Occlusion
by AHS
Summary: In March 2007, Cuddy presents House with a new patient who lives in Ghana. Confused by the distance and Cuddy’s obsession with the case, House follows her to Africa to diagnose the patient, a doctor who has a nasty habit of occluding her past. Huddy.
1. Prologue

Hot couldn't even begin to explain the climate of the sub-Saharan Africa in the midday. In early April, when a good amount of the world was enjoying temperate or even cold weather, northern Ghana was baking with temperatures that easily reached the high forties in the shade, if you could even find any. There definitely wasn't any shade available for the lone woman crossing the rural savannah dressed with barely her hands showing on the handlebars of her rusty old bicycle, a young boy holding a bag sitting on the rack behind her. She bumped over the uneven dust road as she had since leaving her clinic in Sumpini, a tiny village in the province of West Gonja. As a gust of wind from the tail-end of the Harmattan lifted the edge of her linen skirt, the woman made a sharp turn to ride down a footpath towards a thatch hut in the centre of a sickly-looking crop of early season millet. The bike fishtailed slightly as the boy leaned over, letting the very ends of his fingertips brush the bumpy heads of the stalks. As they approached the house, a woman wearing an old t-shirt and a dusty but richly coloured sarong stepped out, her hand held over her brow as she watched the other woman dismount the bicycle after the boy.

'I'm glad you could come, dɔketa.'

Grabbing the clunky bag from the boy, the doctor simply nodded before walking up to the other woman. The boy sat down in the shade of the house, his knees held to his chest as he listened to the screaming coming from the house. Seemingly unfazed, he picked up a piece of millet and began pulling the seed off of it.

'Kwaku,' said the older woman as she looked longways at the boy. 'Fetch some water for Ama.'

'Where is she?' asked the visitor shortly.

'In the back room,' the Ghanaian woman replied, gesturing to the inside of the house and letting the doctor pass her.

Inside of the house, the temperature dropped a good fifteen degrees, and before going into the back room, the doctor paused to take off her hijab, letting her dark hair down for only a moment before tying it back with an elastic. Unbuttoning the top few buttons of her jilbab, she picked up her bag again and with another nod to the other woman, followed her to the source of the screaming.

'We sent Kwaku as soon as her waters broke,' the woman said in a hushed voice as she pushed the door open to a small bedroom. Two other women were crowded around a girl who was sweating profusely.

The doctor, never one for conversation, took a few steps toward the girl, bending down to pull her legs farther apart to take a good look at her vagina once she noticed the dirt floor under the woman had already turned into ruddy mud. Speaking quick Twi to the other women around her, the doctor pulled latex gloves from her bag and snapped them on.

'Hold her legs; press them toward her chest.'

The first wife of Kwame, the woman who had let the doctor in, scuttled from the room and gathered a bucket of water from the second wife's only son Kwaku. When she came back in, she took the old bucket of water sitting between the second wife and the teenager who was giving birth, his third wife. On the other side, the girl's mother held her hand, and a moment later, the second wife was dabbing at the third wife's forehead.

'Pia,' said the doctor calmly, and the girl gritted her teeth as she pushed. After a few more solid pushes, the baby crowned and the doctor slipped her fingers between the baby's head and the vagina to coax up the skin, which was scarred by the female circumcision that Ama had received in her childhood. 'Almost there.'

A minute later, the baby's head popped out sending a gush of fluid onto the ground. Ama visibly relaxed as the doctor helped pull the baby's shoulder out, and within a couple of minutes, the baby was wrapped in a kente cloth and handed to the second wife, who quickly got to work cleaning the baby with the fresh water. As the women worked, the doctor delivered the placenta and handed it to the first wife before digging through her bag and pulling out her scissors and some thread to disconnect the baby from the placenta. Once she finished, the first wife took the placenta to another room where the father awaited.

'Berimba,' murmured Ama's mother as she looked at her grandson, who laid squealing in the second wife's arms. Ama smiled exhaustedly.

With a small smile on her face, the doctor took a needle and rubbed it with an alcohol patch before smearing iodine on the new mother's perineal area and sewing her up. Ama hissed a few times in pain, but the doctor had always been quick with stitching and made all attempts to keep it a non-event.

Once her job was done, the doctor walked out into the hall and looked down to see the local witch doctor picking through the placenta, examining the bloody hunk. She watched from a distance for a moment before the father noticed her and walked toward her, pressing his hand to her back as he brought her back to the front room. He averted his eyes until she had placed her hijab back on her head.

'Meda ase, dɔketa,' he said with a smile when he turned back.

'It's my job,' she answered quite matter of factly, snapping her gloves off and placing them in a Ziploc in her bag. 'I'm sure you're proud to have another son.'

The man nodded before giving her a concerned look. 'You have some blood on your face, doctor.'

She furrowed her brow before reaching up and brushing her fingertips to her upper lip, pulling them from her face to look at the bright blood that suddenly started gushing from both nostrils. Blinking, she dropped her bag before staring blankly at Kwame, who reached out to grab her arm as she crumpled to the ground, her eyes rolling back in her head. As her body began to spasm, he pinned her down, soon joined by his first wife, who threw herself over the doctor, pressing her hands on the younger woman's shoulders.

'Kwaku!' Kwame screamed, and the boy came down the hall. 'Take the doctor's bicycle and go into Sumpini; tell Anna to call the hospital in Kumasi.'

The boy, a look of terror on his face, ran past the three adults as the first wife dumped out the doctor's bag and picked through the contents, finding an orange bottle and twisting it open as her husband held the doctor down. Reading the bottle in a panic, she tipped the doctor's head back and snapped the end of a plastic ampoule off before squeezing drops into the doctor's nose and holding her breath as the doctor's seizures stopped slowly, leaving the woman lying motionlessly as a drop of blood ran down the side of her mouth. The first wife leaned over her, pressing the woman's hair back from her face as she looked her in the eyes.

'Are you all right?' she asked as the doctor stared blankly at the ceiling. 'Can you hear me, Dr Chase?'


	2. Chapter 1

In 1999, the band The Bloodhound Gang released the album Hooray for Boobies. Although it is best known for containing that song about doing things that should only be done on the Discovery Channel, there was also a track called 'The Ten Coolest Things About New Jersey.' After ten seconds of complete silence, the album moves on to the next song because, as any New Yorker can tell you, there's absolutely nothing cool about New Jersey.

This was definitely the case during the always-wonderful nor'easter. Like the hurricane version of a deadbeat relative, the storm had settled in and had absolutely no intention of leaving in the near future. The Millstone River had already gone far beyond flood stage, the waters flowing into small river towns and causing insurance companies to carefully review flood coverage to assure that they would screw over as many consumers as humanly possible. Technically, New Jersey was in a state of emergency, but that didn't stop the doctors of Princeton-Plainsboro Teaching Hospital from coming in to do their jobs, especially the three doctors whose souls belonged to Dr Gregory House. No, there they sat around their glass table, all three secretly wondering if they'd be able to make it home at the end of the day as they pretended to actually pay attention to the squeaking of a dry-erase marker as it ran over the laminated surface of a white board. The pattering of rain on the windows lulled them far away from anything vaguely important, and it was only the thunder and sudden whack of a cane on the table that brought them all back to earth.

'Healthy twenty-nine year old female, works and lives in sub-Saharan Africa, right in the middle of her job has a bloody nose and goes into seizures; when she wakes up in the hospital, immediately arranges for release and goes back to the rural village where she lives despite flu symptoms,' said House, one hand gripping the edge of his white board where he'd written down the symptoms he'd acquired from _his_ fearless leader. 'Vaccinated against typhoid fever, rabies, yellow fever, influenza; apparently takes her malaria pills regularly.'

'Do we get to _see _this patient?' asked Eric Foreman as he looked at House, his hand held in front of him almost disbelievingly.

'Lives in _sub-Saharan Africa_,' House repeated as he snapped the cap back on the marker, throwing it in Allison Cameron's general direction before grabbing the back of a chair and pulling it out, slumping into it as he looked at the three other doctors. 'Have at it.'

'Aren't these symptoms a little general?' asked Robert Chase, leaning against the table with his hands clasped together. 'I can tell you plenty of conditions that involve nosebleeds, flu symptoms...'

'And seizures?' House continued, raising his eyebrows haughtily.

'Seizures are a common malady,' replied Cameron, looking at House dryly as she twisted the cap of the marker.

'The climate could have caused her nosebleeds, muscle pain comes from dehydration,' said Foreman. 'Hell, all of the things you've told us so far could be related to just living in Africa!'

'I've a better question,' said Chase, leaning forward even more. 'Since when do you care about someone half a world away with no really juicy symptoms?'

All three of the younger doctors stared at him, but House was unfazed, instead leaning back in his chair and putting his legs up on the table.

'Do we at least get her medical files?' asked Cameron.

'No files,' House replied, extending his arms toward the ceiling. 'Think on your feet.'

'Is this a test?' asked Chase. 'All right, malaria.'

'House said that she takes her prophylactic,' Cameron said, crossing her arms as she looked sideways at Chase.

'And I also tell my dentist that I floss every day,' snapped back Chase, raising his eyebrows.

'Ew, Chase,' said Cameron, her face twisting. Foreman just rolled his eyes.

Chase continued. 'If the dryness caused the nosebleeds, the malaria could have caused the seizures and the flu-like symptoms.'

'Could be lupus,' said Foreman with distaste.

'It's never lupus,' said House with an exaggerated sigh.

'House, there are literally thousands of illnesses that someone could contract living in Africa,' explained Cameron. 'Trying to decide on one of them with just the few symptoms you've given us is ludicrous. It's like a needle in a haystack. Can't you give us any more information about the patient?'

Picking up his cane from the chair next to him, House reached up and smacked the end to a small yellow square on the board. 'Cuddy provided me with this absolute treasure trove of information.'

'One Post-It note?' asked Cameron resignedly. 'How about an epileptic with a co--'

'What does she do as a job?' interrupted Foreman.

'Doctor,' replied House quickly.

'Oh yeah, that totally narrows down the list of things she could have contracted,' Cameron groaned sarcastically.

'Chagas,' offered Foreman.

'Wrong continent,' snapped House.

'Acute intermittent porphyria,' said Chase.

'Seizure stopped immediately upon administration of midazolam.'

'All right, Jervell and Lange-Nielsen syndrome.'

'Krabbe disease,' said Cameron.

'Ring chromosome 20 syndrome,' continued Chase.

'You're all just shooting blanks today,' said House with a half-smirk. 'Come on, kids. Surely you can do better than this.'

All three leaned back, a perfectly choreographed response to any and all of House's jabs. There was a huge period of silence, the only ambient noises coming from the people walking down the hallway, the clack of the blinds and the tapping of rain against the floor-to-ceiling windows. House looked up at the clock in his office, watching it tick-tock away the seconds before Foreman finally spoke.

'Tropical ataxic neuropathy,' he said strongly, glaring at the side of House's face. 'If this year was particularly dry in Ghana, then she could have cyanide poisoning from cassava that hasn't been cleaned properly.'

The other two ducklings looked at him questioningly.

'Dr Charles mentioned it to me,' he explained, his hands clasped on the table in front of him. 'It's a root vegetable that's grown in Africa, but it has to be processed a good deal before consumption because it has cyanogenic glucosides in the forms of linamarin and lotaustralin that are converted into cyanide in the presence of linamarase.'

'And what are some symptoms of TAN...?' asked House, raising his eyebrows expectantly.

'Ataxia, vertigo, acute onset, muscle weakness, hyporeflexia...'

'And what about the seizures?'

'Well, Cameron brought up a good point,' Foreman said, motioning to Cameron. 'We have no idea whether or not she has a history of seizures. If she already has nerve damage from a seizure disorder, then the consumption of poorly prepared cassava would probably just set her brain over the edge. In fact, how do we know for sure that she even had a seizure? For all we know, she could have just suddenly had trouble walking, her legs gave out, she was dizzy...'

'All right, I'll consider that diagnosis. Anyone else have a guess?' House asked before looking down at his watch. 'On the other hand, I have a previous commitment, so I'll leave you three to come up with something useable. You better have your homework done before daddy gets home, kids.'

Walking around the table, he plucked the marker out of Cameron's hands and flung it at Foreman. The doctor caught it against his chest and stared at House.

'You gave a plausible answer unlike these two geniuses,' House replied, walking over and patting Foreman on the head. 'Congratulations! You get to write on the big white board!'

House went to the door and pulled it open, hobbling out to the hallway and looking both directions before walking off. After he was gone, Chase and Cameron looked over at Foreman longingly as he clasped the marker with a proud smirk glancing over his face.


	3. Chapter 2

Massages are always very nice; anyone who has had a good Swedish massage can tell you that. There's just something about lying down on a heated, cushioned bed in a darkened room, the sounds of whatever ambient CD the masseuse chose that day running smoothly through your mind, the feeling of warm oil on your bare skin, the relief that flowed from the body as muscles were loosened... all of it just came together as something nearly (or slightly beyond, depending where the massage was taken) sexual. This was definitely the case for Lisa Cuddy as she laid face-down on the massage table, her face surrounded by an insanely soft cushion as her masseuse worked on her lower back. She sighed, a relaxed smile coming over her face as she listened to the Tibetan chanting that her masseuse had put on for the occasion. Outside, it was rainy and disgusting, but in here, she was in a cocoon of happy loveliness.

Her eyes cracked open as the masseuse lost contact with her, but only a moment passed before his fingers tapped back on her spine, leaning down to whisper in her ear.

'I'll be back in just a minute,' he murmured. 'Just stay relaxed; focus on the music and let yourself go.'

Another few seconds passed before there was the rolling noise of a pocket door opening and closing, leaving Cuddy alone in the candlelit room. She breathed in the jasmine oil that warmed in the censer in the corner of the room, cuddling farther into the headrest. She drifted until there was the whirr of the CD reaching the end and starting over, and soon, the door opened again and she heard the familiar thump of feet coming toward the table. There was the squirting sound of massage oil as the masseuse sat down on his chair and rolled to her thigh, rubbing his hands together before uncovering her leg and beginning to run his fingers down her thigh.

'Augh, your hands are too cold,' she said drunkenly.

He didn't respond, but she didn't particularly care considering that his hands were rapidly heating up. She let herself drift as his hands moved down to her feet, carefully running down every tendon before there was the rolling sound of the chair again. His hand rested on her neck as he leaned forward and Cuddy was suddenly hit with a very unexpected and unwanted whiff of a familiar cologne.

'Your feet seem a little swollen,' said a sarcastic voice by her ear. 'Perhaps there's finally a miniature Cuddy on the way?'

Shooting up, Cuddy leaned on her elbow with the blanket held tenaciously to her chest as she glared at House. 'What the _hell _are you doing here? This is _supposed_ to be my golden time away from you!'

He opened his mouth to answer, but she managed to interrupt him before he even started.

'How did you even get in here?'

'Said I was your husband,' he said with a snarky grin. 'Maybe you should try talking to your masseuse every now and then and he'd know that your heart is far too cold for meaningful relationships.'

A dark glare. 'What are you doing here, House?'

'I need more information on the Post-It patient.'

She seemed flustered. 'What do you need to know?'

'Has she had seizures before?' he asked with raised eyebrows.

'I'm pleasantly surprised,' she said. 'I thought you would ask--'

'And why exactly do you care about some doctor all the way in Ghana?'

'... that,' Cuddy said, pinching her lips together. 'The history I received had nothing about previous seizures.'

'Is she the daughter of a benefactor?' he asked, leaning forward slightly.

She leaned to meet him. 'It really shouldn't matter one way or another. Get out of here, House.'

He hesitated and she gave him a dirty look.

'Out.'

'Can't I at least see--'

'I said _out_!' she said with a huff, pulling the blankets tightly over herself before thumping back down into the headrest. When she spoke again, her voice was slightly muffled. 'And send my masseuse back in.'

Thunk, thunk went his cane and she finally relaxed again when the pocket door rolled open. Within a minute, her masseuse was back, his hands quite warm. She sighed.

'Your husband seems very nice,' said her masseuse as he lifted the covers so that she could turn onto her back.

She snorted a bit. '_Right._'

---

A half-hour of bliss later, a very refreshed-looking Cuddy stepped out of the dim room, sighing lightly as she made her way to the receptionist counter. Unzipping her purse, she pulled out her wallet and laid it on the counter as she dug for her credit card.

'How much do I owe you today, Kristin?'

'Actually--'

'I already took care of the tab,' said House, walking up and putting his arm around her shoulders; she quickly shrugged him off.

'Why couldn't this just wait the hour or so it would take me to be back in my office where you'd have the green-light to bother me?' she asked loudly through her teeth.

'Shh, honey,' he said, putting his hand over his mouth dramatically. 'Don't air out the dirty laundry in front of poor Kristin.'

'You're not my husband,' she said before turning to Kristin. 'He's not my husband.'

Kristin smiled uncomfortably. 'Have a nice day, Dr Cuddy.'

Cuddy pinched her lips together and dropped her wallet back in her bag, looking at House with narrowed eyes before turning almost militarily toward the door. He followed after her like a lost puppy.

'I need a ride back to the hospital,' he announced when they got outside.

She popped open her umbrella. 'Walk back.'

'How _heartless_,' he said, gaping.

'Call Wilson,' she retorted, looking both ways before crossing the street to the parking lot.

'Well, he drove me here,' he said, following her sans umbrella. 'It would just be plain impolite to bother him again.'

Yet another look of death as she stopped by her car, pressing the remote. The lights blinked. 'And what exactly do you know about decorum and politeness?'

'Why, Dr Cuddy,' he said, pressing a wet hand against his chest. 'You insult me! How dare you insist that I am anything but a perfect gentleman.'

She sighed and murmured something under her breath before opening the car door. 'Get in the fucking car.'

'How profane!' he gasped as he opened the car door and sat down.

She glanced over at him before starting the car. Flipping on the windshield wipers, she pressed her hand to the back of his headrest and looked behind them before reversing out of the parking spot. In the nearly blinding rain, she crept out toward the road and looked both ways at least three times before finally inserting herself into the absolute centre of a dearth of traffic. Once they were moving at more than a snail's pace, she shifted and laid her chin on her left thumb, her index finger pressing against her cheekbone as her other fingers curled against her lips. 'So did you come just to bother me, or do you actually have an interest in this case?'

'Well, we all know that Africa is just a barrel of laughs,' House replied, mirroring her stance as he watched the road. 'I suppose I'm vaguely interested in what kind of pampered white girl decides to go live in a third-world hellhole.'

'How do you know she's pampered?'

'How else would the case come to you?' he said. 'She's probably from some obscenely rich New York City family and decided she'd go over to Africa to atone for the guilt of drinking the per capita income of Lesotho in Goldschläger the night she lost her lesbian V-card with three girls from her sorority. Probably there for a month, isn't really sick but wants to get out of her mistake by claiming illness. Mommy and Daddy got scared and called the Dean, promising a brand new wing if she can only find a way to cure the girl with the purchased doctorate.'

There was a moment of silence before Cuddy spoke. 'Finished?'

'I could go on.'

A beat. 'I'm going.'

He perked up and looked over to her. 'What?'

'I'm going over there,' she repeated. 'I'm going to Ghana next week.'

He slouched back down into his seat. 'So it really is someone important.'

'I just want your input,' she said, casting a moderately meaningful glance toward him. 'I'd appreciate it if you'd just go ahead and offer up suggestions without pestering me with details.'

'Do you really think you should go there alone?' he asked with some concern.

'Why?' she asked, stopping at a red light. 'Think I need a chaperone?'

'Now that you mention it...'

She reached over and patted him patronisingly on the upper arm. 'I think I can handle it.'

Another silence fell over the car, the only sounds the tapping of rain and the clicking of the turn signal. The light changed and Cuddy took a left turn, the wheels spraying up an arc of water in their wake.

'Why you?' he asked in a tone bordering worry.

When she looked at him, however, he had that certain look of self-righteous asshole plastered across his face.

'I think we both know that this is something outside of your realm of knowledge, Dr Cuddy,' he said with mock seriousness.

Another look of death; these were frighteningly common. 'You're right; it's a favour, but it's a favour you wouldn't care about.'

He gave a dark half-smile. 'You're going to hate it.'

'You know,' she snapped, looking over at him with wide, angry eyes. 'I think that being in a pit like Ghana will be better than having to be in your oh-so-delightful presence.'

He grinned over at her. 'Ooh, snap.'

---

'Any other ideas?' asked House as he walked into the office and looked at the three doctors convening over the glass table.

'You were gone for less than an hour,' snapped Foreman, his eyes focused on an open book. 'How far do you really think we could get without having the patient here?'

'Think of it as a fiendish game of sudoku,' replied House, going over to the whiteboard and scanning over the list of illnesses the team had compiled in his absence. 'There are numbers missing and you just have to look at everything else to get the final solution.'

'In sudoku, there are only nine numbers to deal with,' said Chase. 'And I can't even handle that.'

House didn't reply, instead grabbing up the marker and crossing out more than half of the possible diseases they'd come up with.

'Why did you cross out Addison's?' asked Cameron with exasperation.

'I think a bronze colour to the skin would have been noted in the hospital report,' said House in an undertone.

'What hospital report?' said Foreman in an equal undertone full of sarcasm.

'Who came up with Sydenham's chorea?' asked House, looking at the team.

Chase meekly raised his hand.

'We were pulling straws,' said Cameron defensively. 'With so few symptoms--'

'-- and without seeing the patient, we can't do anything!' interrupted House in a falsetto.

'If you're so great, why don't _you_ come up with something?'

'What fun would that be?'

Foreman raised his eyebrows with a dead-serious look on his face.

'All right,' House said, hanging his cane on the whiteboard. 'Q-fever, schistosomiasis, acute disseminated encephalomyelitis, hepatitis E.'

He turned to the board.

'Visceral leishmaniasis, TAN, leptospirosis, type II citrullinaemia, neuroacanthocytosis, neurosyphilis,' he read. 'I especially enjoy that last one. Nothing like advanced venereal diseases.'

'I still think you should consider malaria,' said Chase, tapping at the glass with his fingertips.

'The doctors in Ghana would know how to diagnose and treat malaria,' said Cameron. 'One of my friends went there one summer during medical school and said that every doctor there thinks that if you have a fever, are vomiting, anything, it's malaria.'

'If she has an abnormal case, they might not have consider it,' replied Chase, turning to face her. 'Especially with few available supplies to really diagnose.'

'How abnormal could malaria be?' asked Cameron.

'The weird shit we see here and you're wondering how abnormal diseases can become?' replied Foreman dryly.

'I think we'll just forget malaria,' House said, still staring at the board. 'Just not exciting enough to warrant Cuddy going out there.'

'Cuddy's going there?' Cameron asked, her eyebrows raised as she looked at the back of House's head. 'Who is this woman?'

'She didn't offer anymore information,' replied House in a dazed tone before turning around to look at his team. 'You know, I think I'll go too.'

All three watched as he left the room, silent until he disappeared from sight.

'Wait,' Chase finally said. 'Is he _serious_?'


	4. Chapter 3

Landing in Accra was very, very odd.

Cuddy woke up, according to the navigation screen, somewhere over Guinea and then again over the centre of Côte d'Ivoire. Apparently, she was _also_ over a large city, but as far as she could tell, a 'large city' was very relative in West Africa. It was only once they were far over the centre of Ghana that the lush green of the countryside became a series of poured-concrete construction sites and dusty ground. Like a child, she pressed her face against the window and watched the ground go by as they dipped closer and closer to the earth. There was the thunk of the wheels landing on the ruddy pavement of the Kotoka International Airport and they taxied along passing hangar after hangar, cargo plane after cargo plane. When they finally stopped, they were in front of a garishly painted building with smiling faces welcoming them -- Akwaaba! -- to Ghana.

'Have you ever been to Ghana before?' asked her seat mate, a tall black man who wrote on his immigration form that he was from Burkina Faso.

'No,' she said with a smile. 'First time in Africa, actually.'

'It's a beautiful country,' he replied. 'How long will you be staying in Accra?'

'Just a night,' she said. 'I drive up to Larabanga tomorrow.'

He laughed. 'I'd stay in Accra.'

She gave him an uncomfortable smile.

Two hours later after crossing the jet way, being shuffled through immigration and baggage claim, Lisa Cuddy finally made it through to the lower level of the airport. Just inside the door, a woman dressed in traditional clothing peddled curios to new tourists. After the security guards checked her claim tags, she walked outside into the humid air of the mid-morning. Dozens of people waited in a fenced-off area as green-uniformed police patrolled the glass doors. Over the heads came a sign: Dr Lisa Cuddy. The man holding the sign smiled at her with stunningly white teeth and greeted her before taking her bag and walking toward the car park. People swarmed around them in an attempt to eventually get a tip from the obviously well-to-do American, but the taxi driver simply walked to his car, threw her bag in and then opened the back seat door for her. Once he started the vehicle, they made their way to the edge of the car park before he turned off the engine of the car.

'We wait here for a minute, yes?'

She looked at him sideways. 'What are we waiting for?'

He didn't immediately answer, and after a period of silence, she just put her chin in her hand and looked out of the window. Pop music in Ga, one of the local languages, hummed on the speakers of the car, the taxi driver lightly singing parts of it. After about ten minutes, a man wearing a yellow shirt came up to the car and handed the driver a ticket. Once the ticket was in hand, the driver started up the engine again and they were off.

Again, Cuddy found herself pasted to the window. There were so many colours, so many textures, so much everything. Men on a bank were doing the job of a lawnmower with machetes, a man in the suburbs was weaving cloth on a huge loom. Women and men alike walked about with baskets and other things piled atop their heads.

'You want? Very nice?'

Cuddy jumped, ripped away from her musings by a man who'd walked up to the car holding a display of highlighters and pens. Behind him, a man was swinging air fresheners for sale in the face of some man who sat, stony-faced, in his Jaguar.

'Oh, no, thank you,' she said with a blushing face as the man walked off.

It was the same at every stoplight. At one, a woman was trying to sell pears as a man carried around a bag of Milo, a local energy drink, promising to Cuddy that it was more powerful than anything she'd get in America. She was thankful when they moved on, but annoyed whenever they hit another stoplight. The next one was a man selling Western magazines, another one featured a poster showing the currency changes, and yet another was trying to sell USB cables.

That one was obviously the oddest of the bunch.

Along all of the streets, little booths were set up selling things like drinks (it seemed popular to drink water out of little bags rather than out of a bottle), phone cards, dried fish, fruit. As they got farther down into the Osu neighbourhood of Accra, the traffic became increasingly worse. As she looked down the alleys, she could see entire marketplaces and a suspiciously high number of live chickens. Children in vibrant uniforms walked down the streets on their way to school, each wearing a fabric imprinted with her school's seal. Lines of tiny Ghanaian children dressed in bright yellow followed behind an adult with a hat matching their own.

After a bit, they turned in to the car park in front of a rather podunk looking hotel, though she had to admit, it did look a lot better than ones that she'd seen on the drive. Purse over shoulder, she slipped out of the car and looked up at the awning of the place with a half-grin.

'Welcome to the Niagara Hotel,' said a man at the top of the stairs before he walked down to take her bags. 'You are Dr Cuddy?'

'Yes,' she said, watching him take the bag. 'Thank you.'

She followed him into a shaded lobby, studying the Egyptian papyrus painting behind the counter. Despite the predominant Christ-centred-ness of this part of country, it was obvious that the owners here were Muslim; there were passages from the Koran written in flowing Arabic cursive all over the walls of the office beside them.

'Incredible!' said a man's voice behind her, and she froze. 'Of all the places, who would have thought I'd find you here!'

A hand landed on her shoulder and his face came around to look at her.

'What are you _doing_ here?' she hissed, though after seeing the bulk of the town, she was rather happy to see a familiar face, even if it was one of the most aggravating people in the history of man.

'Americans get proposed to a lot over here,' House said with a serious nod. 'I wouldn't want Princeton-Plainsboro to lose its Dean of Medicine to some lucky Lebanese-Ghanaian.'

'Right,' she said, turning and pressing her elbows to the counter. 'I'm _sure_ that's why you're here.'

A half-smile as he held up a key hanging from a large hunk of wood. 'I already have us checked in.'

'In the room that _I _booked?'

'Number 213. My bags are already up there.'

'It's a single room, House.'

'All the better to get our groove on.'

She rolled her eyes at the back of his head as he walked past the bar and to the edge of the building before looking back at her.

'Planning on coming?'

With a huff, she reached down to pick up her bag, but in the moment between when he said something and she reached, someone had already grabbed the bag and started running up the stairs. House watched after him before looking back at Cuddy once more. She grumbled and walked to him.

'They're not exactly cripple-friendly here,' he said, grabbing the rail of the staircase with his left hand and carefully heaving himself upward.

'Do you need help?' Cuddy asked with concern, but House didn't grace her with a response.

When they got to the top floor, House kept following after the steward, but Cuddy stopped to look at the area around them. Behind the hotel, a woman stood on a rooftop hanging tiny shirts and socks for the child who was asleep tied to her back. Through the other window at the top of the stairs, she could see traffic congestion and a massive Mentos ad, but it all seemed to be considerably less hectic than New York and perhaps even Trenton.

'Cuddy,' came House's voice from down the hallway. 'Quit being pensive and get down here.'

Turning away from the window, Cuddy walked down the dark hall past oddly numbered doors (twelve, seven, five?) before reaching room thirteen where House was handing a twenty-thousand cedi note to the porter. He took it thankfully and let Cuddy in before walking into the hallway and disappearing down the end of it. Cuddy took a few steps forward and shut the door behind her before going past House and looking out at the street below.

'Have you ever been to Tijuana?' asked House, but didn't give her a chance to respond. 'This place is exactly like it, but without the donkey shows.' He paused, looking up at the ceiling with one eye squeezed shut. '... as far as I know.'

She turned away from the window. 'Why are you here, really?'

'I liked the case.'

'Enough to come to Africa?'

'Is that the answer that will get you to stop asking questions?'

She pinched her lips together and tipped her head, giving him a dark look.

'Perfect,' he said with a half-smile.

---

He woke up in the middle of the night and watched as Cuddy's shadowy figure paced back and forth in the room. After a few minutes, she looked out the window to look at lightning in the distance before walking to the door and out to the hallway. She left the door slightly ajar, a beam of light landing directly on House's face. Throwing his legs off the edge of the bed, he sat up, his eyes half-closed as he fumbled around in the dark for his cane. Finding it, he stood and followed after her.

By the time he reached her, rain had started falling, the beat of it quickly increasing into a roar. Her eyes were closed, her face toward the sky as water soaked her pyjama top. He leaned next to her, and for a moment, she was on the defensive before noticing it was House next to her rather than some random man wanting to be her 'friend.'

'Did I wake you up?'

'No, I was hurting,' he lied. 'Are you all right?'

'Jet lag,' she lied in turn. 'I took a zolpidem, so hopefully I'll be able to sleep soon.'

'I wouldn't mind a zolpidem right now,' he replied. 'Come on, let's go back to the room. You're soaked.'

In the room, Cuddy turned the lights on and he watched as she went to the wardrobe and pulled out a bright orange bottle. Fishing out a circular pill, she walked to him and dropped it in his hand, watching clinically as he swallowed it dry. Without a word, she went back over and took out a new set of pyjamas, walking into the bathroom. A moment later, the shower started and he laid back, scanning the ceiling as the double lull of the shower and rain drummed in his ears.

He'd already drifted off when she came back out, turned off the light and slipped in bed with him, her hair exuding the smell of her shampoo. He opened his eyes and looked at her outline in the half-light.

'Tell me about the patient,' House said as rain pummelled the roof.

Cuddy laid with her back to him and her face toward the window; the power had been out earlier when they got into bed, so they hadn't bothered closing the curtains. Now with the power on and the air conditioner running, it really wasn't very different than before except that they were actually _comfortable_ rather than sweating profusely atop the sheets.

'Twenty-nine year old Caucasian female--'

'You know what I mean,' he said as he turned over in bed to face her back.

'I really don't know much more than that,' she slurred, keeping her back to him. 'She hasn't been forthcoming with any information; it was only through being contacted by the hospital in Kumasi that I even knew she was sick.'

House was silent for a minute. 'Why did they call you?'

He waited for her to speak, but her only response was a light snore and the even breathing of sleep.


	5. Chapter 4

'What do you _mean_ the car isn't working?'

It was a mere seven hours later when House and Cuddy were sitting at a restaurant at Linda d'Or, a wee oasis in the town of Bunsu that was a little less than halfway between Accra and Kumasi. House didn't look up at her outburst, instead choosing to continue picking at the chicken curry he'd been served -- did they have any clue what white-meat chicken was in this country? -- whilst she ignored her chips and yelled at their driver. Covertly, he reached over and took a chip, eating it slowly. The second time he made an attempt, she reached down and blindly grabbed his finger violently.

'You could wait here and I will catch a car back to Accra,' said the driver nonchalantly. 'I will be back in four hours.'

'I'm _not_ waiting four hours!' snapped back Cuddy.

'We are not close to a large city,' replied the driver. 'You cannot get a taxi here, but I'm sure you'd be able to find some space on a public transport.'

She paused for a long moment before half-shrugging and sighing. 'Fine.'

House stopped mid-chew. 'Cuddy, no.'

'Shut up, House,' she said, looking back at him.

He swallowed then reached toward her, letting his fist thud onto the table when he realised he wasn't close enough to grab her. 'You don't want to be on one of those vehicles.'

'No, House, _you_ don't want to be on one of those vehicles,' she replied, and he looked at her rather doubtfully.

'You're going to regret this decision,' he said in an undertone, but she didn't appear to hear him.

'Bring our bags to us and try to find a public transport,' she said to the driver as she turned back to the table and sat down, pulling herself to it with the long scree of metal on concrete.

Once the driver walked off, Cuddy took a bite of her sandwich and watched a large lizard crawl up the tall curtains that framed the open wall of the restaurant. At the bar behind them, a woman was clinking glasses loudly and came by a moment later with a basket holding a Fanta for House. She set it down and popped the top off; House took a long straw from the proffered package and dropped it in before taking a long sip.

'I hope the public transportation here isn't like the public transportation in Egypt,' he said quietly, raising his eyebrows and not looking at her.

'You lived in Egypt when you were a _kid_, House,' she replied, picking up a chip.

'I'm just saying it's going to be an adventure,' he murmured. 'And that you shouldn't make rash decisions that will end up killing both of us miserably when your panties are in the process of falling to the communists.'

From over her coffee cup, Cuddy gave him a blank look for just the moment it took her to understand his euphemism at which point she narrowed her eyes and took a sharp sip.

By the time the driver came back, they were finished with their lunches. 'There is a tro-tro heading to Kumasi and there's enough room for both of you. It is not an express tro-tro, but it's the only one available.'

House threw a pleading glance at Cuddy, but she didn't seem to notice, instead standing and picking up her bags. With an unhappy grunt, he stood, throwing his pack over one shoulder and then following her out of the restaurant. It had started sprinkling outside, the little bit of rain helping the humidity oh-so-much. He relished in her sudden look of taken-abackness as she looked at the questionable van which was covered in Korean and absolutely packed with people.

'There's room for us?' she asked the driver, who had come around and rolled open the door for them.

He looked between the van and the two of them a couple of times before nodding. 'There are only sixteen people in.'

She gaped slightly. 'I don't think...'

House walked past her, grabbing her purse on the way to the van before reaching through the door to pull down a jump seat on the second row. He shoved his bag and her purse under the seat and then sat, looking over at Cuddy. 'Hey, I'm sure the guy in front of me would just love for you to get in his lap.'

The driver took this as a sign of mutual approval and turned to retrieve their bags from the ground around Cuddy, walking behind to place them in the back doors then strap the door closed. Moving with hesitance, she walked up to the van and stepped up, pausing for a moment before sitting down on House's lap. He pushed her over so she was more on his left leg than his right.

'You're already up there,' he muttered in her ear. 'How about a lap dance?'

As the door shut, Cuddy pinched her lips together and glared at him. He smiled a bit at her response.

'So,' he said as the driver got back in and started the process of turning the van on. 'Should we talk about the case or is this too unprofessional of an environment?'

'House,' she said with exasperation as the van began making its way to the highway. For a moment, she seemed like she was going to actually give him some information, but then she sighed. 'I'm sure the dean of the hospital will be more than happy to explain _everything_ to you once we get to Kumasi.'

When the van started driving off, the rain began pouring, thus making it obvious that the wiper blades hadn't been changed in a good while nor had the huge crack in the windscreen even been vaguely taped. As the water drip-dropped onto the dash, House turned awkwardly and wrote down the symptom list on the fogged window.

'Hepatosplenomegaly,' Cuddy said. 'And anaemia.'

House looked at the available space on the window before just writing _HSM_. 'What other symptoms did you forget to tell me?'

'I didn't _forget_ to tell you anything.'

He looked back at the window. 'It's probably leptospirosis. Contaminated water, the lovely rodents of western Ghana...'

'Leptospirosis wouldn't cause the seizure or the hepatosplenomegaly.'

'Fine, then we've come this far to diagnose a case of malaria.'

Cuddy tipped her head, obviously aggravated. 'I don't think you have enough information to diagnose her just yet.'

'And whose fault is that?'

Cuddy reached up and pinched his chest.

House thwacked her hand away. 'You're the one who got me involved in this.'

She stared straight at him. 'I've told you want I know, and besides, I didn't ask you to come with me.'

---

'Cuddy,' murmured House a moment before he began shaking her. 'Everyone's getting off.'

Cuddy opened her eyes slightly. 'We're in Kumasi?'

He shook his head. 'Customs checkpoint. Grab your purse.'

Without much ado, House pushed her off of his lap and she leaned down to grab her purse before jumping out onto the dusty asphalt. She stood to the side as the others got off, waiting until everyone had alighted before following after House. She quickly realised the mugginess of the van wasn't just because they were crammed in like sardines -- the weather had become much hotter and there wasn't even a single cloud in the sky to offer relief. Grabbing up the corner of her purse, Cuddy was digging through the bag for a handkerchief to tie around her head when someone grabbed her arm and hissed to get her attention.

'_Obruni_,' the uniformed man said sternly as he pointed to a rusty-tin-roofed shack off to the side.

'I'm sorry?' Cuddy asked as he started tugging on her arm.

When Cuddy looked up, another man had taken House by the arm and was leading him in her direction. Once at the door of the shack, the man leading Cuddy opened the door and both she and House walked in, both careful not to slip on the damp poured-concrete floor. A fan in the corner of the room blew softly, rustling the papers on the desk behind which an imposing Akan sat, his concentration focused on a roll book until the guards brought House and Cuddy up to him. The man leading Cuddy said something in Twi and the man behind the desk looked up, tapping the end of his pen on the pad of paper. For a few long moments, the only sound was the dull thud of the metal on the paper. He leaned forward.

'Papers,' he articulated carefully, raising his eyebrows expectantly.

Flustered, Cuddy dug down into her purse before looking at House's hand, which held both of their passports. 'When did you--'

'Where are you going today?' the man asked as he flipped open House's passport to check his visa.

'Kumasi,' House said, putting out his hand with the expectation that his passport would be handed back to him. The man just stared at his hand before opening Cuddy's passport.

'What is your business there?'

'We're doctors,' Cuddy replied with a smile, but the man didn't even nod. 'We're here to provide--'

The man's eyes snapped up to them for a moment before shuffling their passports toward himself deliberately. He leaned back lazily, but the look on his face was one that was purely business. 'How much does getting to Kumasi mean to you?'

House narrowed his eyes. 'We were asked by a Ghanaian doctor to come here to provide a service.'

'That is not a valid reason for him to give you passports back,' the man who had led Cuddy in said smugly. 'That doctor is not here and I don't see you providing a service for any of us personally.'

'Give us our passports back,' House replied quickly, taking a step forward and putting out his hand more emphatically.

Grinning, the man leaned back further in his chair, tapping the passports on his thigh.

'Please, we need to get back to our ride so we can get up to Kumasi,' Cuddy said, putting herself slightly between House and the man. 'Dr Kwame Agbo of the Okomfo Anokye Teaching Hospital in Kumasi is expecting us this afternoon.'

'I asked you how much getting to Kumasi means to you,' he replied. 'Perhaps three million cedi?'

'No,' snapped back House. 'We're not paying you anything.'

At the same moment, however, Cuddy was already digging into her purse. House grabbed her hand.

'We're not paying him, Cuddy.'

'It's three-hundred dollars, House,' she said, brushing his hand aside.

He pulled her purse from her shoulder, quickly shifting it around to his other side as he looked at the man.

'If the lady wants to pay, let her pay,' the man replied, dangling Cuddy's passport over the desktop.

As Cuddy tried to reach around him, House grimaced before speaking breezily. 'Three-hundred thousand cedi.'

The man and his associates laughed. 'I said three million.'

'Five-hundred thousand.'

The man tipped his head a bit. 'Two-point-three million.'

House shook his head fervently. 'Seven-hundred-and-fifty thousand.'

'One-point-five million, final offer.'

'Offer not accepted,' House replied. 'Nine-hundred-and-sixty thousand.'

The man looked back at his associates; there was a short Twi exchange before he turned back. 'Offer accepted.'

Opening Cuddy's purse, he retrieved forty-eight of the twenty-thousand cedi bills she'd been given at the airport. As soon as he threw it down, the man picked the pile up and quickly counted it before tossing their passports across the desktop. House took both of them again, placing them in his back pocket as he handed Cuddy her purse. The man pulled open the top drawer of the desk and slipped in the bills as he watched the two of them leave. Once they stepped outside, one of the men snapped the door shut behind them.

'They don't stop private cars,' grumbled House.

Cuddy gave him a dark sideways look, but House didn't notice, instead electing to stare straight ahead. He sighed dramatically.

'Well, at least it stopped raining,' he muttered darkly as they stepped into the sun.

'Huh?' asked Cuddy as she followed his gaze; her shoulders slumped and she gaped. 'Where's the van?'


	6. Chapter 5

[A/N: This is different, I promise. This NaNo round, I'm actually finishing this, I swear! I'm confident this time!]

---

'It's fucking hot,' growled House, staring at Cuddy's back as she tried to flag down passing cars.

'Well if you'd hobble on over here and help, maybe we'd be able to get to Kumasi and into air conditioning,' snapped back Cuddy.

As the eighth car passed and ignored them, Cuddy gave up and walked back to House, sitting down next to him on the stairs. He handed her his jacket and watched her place it over her head, covering her exposed neck from the sun. Nothing around them moved. A couple of minutes had passed before there was a constant metal-on-metal squeaking and they both looked over as a man went by on a bicycle, a dead goat strapped to the bike rack with its neck bouncing limply as he hit a pothole. The awkward grossness of the moment compelled Cuddy to converse with her stair-mate.

'How the hell are we going to get our luggage?' she muttered with a grimace, staring out at the road, her eyes vaguely following the man on the bike.

'We aren't,' he said flatly as he reached down to massage at his leg a bit.

'What an optimist you are,' she replied, pulling the jacket farther forward on her head.

'Not one of my strong suits,' he said as he looked down the road upon hearing the tell-tale sounds of a questionable Ghanaian automobile.

She smiled a bit, looking over for a moment as House looked at his watch and then got up with a hiss, walking over to the road sans cane as the van drew closer.

'House,' she replied, standing up and grabbing his cane. 'House, I was kidding. I was just ma--'

The van passed them and for a moment, it appeared they'd missed another mode of transportation, but not fifteen feet down the road, the van came to a halt and the side door rolled open. House and Cuddy looked at each other, House wearing a very self-righteous look. He took his cane and began walking toward the van as a bleach-blonde white woman jumped out onto the dust.

'Surely _yevu_ shouldn't be in a random area like this a mere four hours from nightfall,' said the woman in an amazingly thick British accent as she walked toward them. 'Where are you headed?'

'_Yevu_?' muttered Cuddy to House.

'Whitey,' he replied. 'In the east at least.'

'The Komfo Anokye Teaching Hospital in Kumasi,' replied Cuddy as the woman stepped right up to them.

'Oh dear,' she said, placing a hand over her mouth and stepping one large step back. 'You haven't something contagious, have you?'

'We have a meeting with the head of diagnostics regarding a patient,' Cuddy said quickly, waving her hands in front of her emphatically. 'We're doctors.'

'In that case, we'd be more than happy to have you join us,' she said, already starting back toward the van. 'Gemma West.'

'Lisa Cuddy,' Cuddy replied, then reached out to press her hand against House's forearm as she followed Gemma to the van. 'This is Greg House.'

When they got to the door, a large, bodyguard-looking Ghanaian man slipped off the second row jump seat and stepped to the side. Both he and Gemma watched them get into the van, House and Cuddy commandeering the bulk of the second row. Gemma allowed them to get situated before getting in herself. She settled in the third-row jump seat then pulled out the second-row jump seat for the black man to sit upon. He sat down and slide the door closed as the other girls in the van with the exception of the two completely conked out denizens of the back row waved their hellos. Rather than paying attention to girlish niceties, House was more focused on the large black man who seemed so out of place in the gaggle of white women who sat in the passenger area.

'We call him Posse,' whispered one of the girls by his ear. 'We're not entirely sure why he's here; he's with the tour guide.'

House offered her a pitiful half nod before leaning back and rubbing at his leg more. Cuddy looked over with concern but didn't say anything.

'They need to go to the hospital in Kumasi, the... uh...,' Gemma began before looking at Cuddy. 'What was the name again?'

'The Komfo Anokye Teaching Hospital,' Cuddy said, leaning toward the older woman on the first row that Gemma seemed to be speaking to.

The woman -- Phyllis, according to the girl by House's right ear -- said something to the driver and they merged back into traffic, traveling for a few minutes before conversation started up.

'We're going up to Mole tomorrow,' said the girl behind them who had both warned House about Posse and offered the name of the woman in front of Cuddy. 'To see the elephants.'

'We've already been on the road for nine hours,' said another, so far the only one without a British accent, exhaustedly, leaning against the window. She gave a long yawn before continuing. 'We left at four this morning.'

'Tonight we'll stay in Kumasi,' continued the girl who told them about Mole. 'We've been living in the Volta Region for a few months now, so there's a distinct lack of air conditioning and hot showers in our lives right now, and the hotel in Kumasi where we're staying has both. Alice, by the way. Pleasure to meet you.' She gestured to the half-asleep American. 'She's Judith.'

'How did you happen to get here in the middle of nowhere?' asked another girl who turned around from the front window seat.

'Our van--'

'Tro-tro,' corrected the same girl; Alice quickly murmured that her name was Lydia.

'_Tro-tro_,' continued House, more than peeved. '--felt the need to leave us at a customs checkpoint.'

'Not too fond of whiteys, the Akan,' replied Alice darkly but quietly, looking up at the men in the front seat. 'I much prefer the Ewe.'

They continued in silence, Cuddy leaning slightly against House to look out the window -- he found, even in the short time he'd been in the van, that he hated Posse, wishing only that the man would move so that he'd be able to stretch out his damn legs. He wondered for a moment if he should capitalise on the look Cuddy had given him earlier and demand her lap be used for an ottoman, but when she gave a long look at Posse then turned to him and twisted her face into a look of utter annoyance and hatred, he decided against it. It was nice to just have a common enemy for an extended period of time. Happy that he at least didn't have a woman sitting on his lap anymore, he popped a Vicodin and leaned against the window with his hand over his right thigh. After a couple of minutes, Cuddy pushed his hand aside and rubbed at his thigh with the knuckles of her right hand. Alice leaned over the seat to watch them but thankfully didn't continue her habit of inserting random statements into places they didn't belong.

It turned out that they'd been left a little less than an hour from Kumasi, and before long, they started entering the outskirts. The first thing that House saw of the city amused the hell out of him: despite a near complete lack of privately-owned vehicles, there were a couple of stores specialising specifically in rims. Apparently they were in the auto area of the city, as the stores around the rims were devoted to motors. Half-finished buildings spotted the landscape, their concrete walls ending in long metal rods sticking up six feet where the walls should have continued. Many more buildings sat basically completed, but the lack of doors obviously made them unliveable.

'Cow,' Judith murmured lazily, and surely enough, there in the dead centre of a roundabout was a grazing Brahmin cow.

'Bizarro world,' muttered House in return as he reached down blindly and lifted Cuddy's hand off of his leg, holding onto it for a moment before she drew it away to place it backhandedly over her mouth to stifle a yawn.

Finally, after the roundabout, which was marked 'Santasi Circle', they began on the first marked road they'd seen since leaving Accra: Bekwai. On the rails of apartments, clothes laid drying, the dirt and pollution of the city more than likely sullying the hard job the women suffered through for at least ten minutes per item of clothing. It was with relief that Cuddy noted the lanes of the road were now properly marked, the insanely sprawling width of the highway forgone within city limits. At Bekwai Circle, they passed the oh-so-easily-named street Pine then went only about a kilometre more before hitting the aptly-named Hospital Circle. Once they stopped, Gemma told Posse to open the door and he did, jumping out and allowing House and Cuddy out before handing them both of their bags. When he got back in and closed the door, Gemma forced open the window near her and leaned out.

'When you finish your meeting, ask the administrator to call a taxi for you,' she said, holding out a piece of paper. 'Tell him to go to this location; it shouldn't cost much more than twenty thousand cedi, and since it's only ten kilometres away, it shouldn't take too long. We'll go ahead and reserve a room for you so all you have to do is check in.'

'Thank you so much,' said Cuddy, taking and treasuring the piece of paper. 'You've been such a great help.'

'We _yevu_ have to stick together,' Alice said with a laugh as she leaned over Gemma. 'We'll see you at the hotel, yeah?'

As they drove off, Cuddy waved as House shifted his bag to the other shoulder. Turning around, he looked at the building in front of which they'd been dropped off. Although clean and well-manicured, it was painted an awkward Easter yellow and had the related 1960s modern je ne sais quoi going on. The main part of the building was six storeys tall, but shorter buildings connected to it had four or less. According to what he could see of the campus, however, it didn't seem like the shady colonial era building in front of them was going to be used for much longer -- the place was a veritable hubbub of rather modern-looking construction. When Cuddy finally turned, they walked through the dry grass to an overhang covering the entrance. As they passed under a canopy of bright red fabric, House looked back at the bottom of the overhang to study the water stains that covered it.

'Insane that they have all these stairs,' Cuddy said as they made their way past a gate and into the building.

Inside, women in light blue dresses with crisp white aprons and starched white hats walked by clutching notebooks and laughing. Surgeons dressed in scrubs and doctors in street clothes milled about, a surprising number of Caucasians mixed into the group. Cuddy looked at one woman, a middle-aged white clinician walking by looking down at a chart, and crossed across the lobby quickly to reach her.

'Excuse me,' Cuddy said, and the woman looked up at her. 'This is the first time I've been here and have no idea who to ask about how to get to the office of the doctor I'm supposed to be meeting.'

'Who are you looking for?' the woman asked in a thick German accent.

'Dr Kwame Agbo.'

'Ah, diagnostics,' the doctor said, then looked forward and pointed down a hallway. 'Keep going that way and you will find a nurses' station. One of the unit managers should be able to call Dr Agbo for you.'

The woman didn't wait for a response, instead walking a few feet to another group of clinicians -- they all began chatting in German as House and Cuddy walked by.

'Is it just me or does this place seem frighteningly modern?' House asked as they entered the hallway.

'Considering what I was expecting due to our experiences so far...' Cuddy said to him, trailing off before continuing. 'And did you see that construction they're starting? This place is going to be nicer than Princeton-Plainsboro, Jesus Christ.'

'And yet I still wouldn't want to be anywhere even vaguely near here.'

Cuddy didn't reply and her body language wasn't offering any answers to him. They walked on for about a hundred feet before reaching the nurses' station. Three women were sitting behind the counter, all wearing the same blue outfits and prim hats that they'd seen in the lobby. The woman closest to them looked up from her paperwork and gave them a smile.

'Can I help you?'

'We're looking for the diagnostics department,' Cuddy replied. 'We have a meeting with Dr Agbo.'

'Let me call him,' the woman said, reaching over to grab a phone, pushing a few buttons then waiting for a moment as it rang. 'Sorry, could I get your names?'

'Drs Lisa Cuddy and Greg House.'

She nodded. 'Yes, Dr Agbo? This is Nurse Aglago. Drs Cuddy and House have arrived for their meeting with you. Shall I have them wait for you? Thank you, sir.'

Nurse Aglago hung up the phone and stood, gesturing to an empty bench near the windows across from the nurses' station.

'If you'll just wait right there, he'll be down to meet you shortly.'


	7. Chapter 6

Before leaving for Ghana, Cuddy had heard of a phenomenon referred to as 'Ghana time'. It was explained to her thusly: in Ghana, time has absolutely no meaning. People will show up whenever they damn well please and will offer no apologies nor should they expect others to seek out apologies. Everything is straight-up molasses on a winter day and schedule seekers like herself had to be prepared for the eventuality of waiting, like they currently were, anywhere from twenty minutes to several hours. In their case, they were sitting for thirty minutes before House started fidgeting and stood, walking around a bit and rubbing his leg.

'I can stay here alone,' Cuddy said, following his path with her eyes. 'Go to the hotel and lay down for awhile.'

'It's fine,' House said a bit raggedly, stopping right in front of her to take two more Vicodin.

'House,' Cuddy said as she stood.

She was about to say something more to him when a tall, young Ghanaian doctor came hurriedly down the hallway, rubbing the top of his shaved head as he spoke. 'Dr Cuddy?'

Cuddy looked over at him. 'Dr Agbo?'

'It's a pleasure to meet you,' he said in an amazingly accentless voice, holding his hand out to shake hers. 'I'm sorry for running so behind -- there are a lot of volunteer medical personnel here and we sometimes get rather caught up in interpreting between them and non-English-speaking patients.'

'That's perfectly alright,' she said with a smile as they broke the handshake.

'I was educated in America so I completely understand and very much appreciate the American idea of being on time,' he said then turned his attention to House. 'And you must be Dr House. It's an unexpected pleasure to meet you, sir. I'm sure you know that your reputation proceeds you.'

'Of course it does,' House said, taking his hand from his thigh to shake Agbo's.

Agbo looked between House, his leg and Cuddy, but when Cuddy didn't offer any concern, he simply nodded and clapped his hands together. 'Should we go to my office then?'

He turned, walking back in the direction of the lobby with House and Cuddy following along after him. They walked completely through the lobby, narrowly dodging a few Americans who seemed poised to ask Agbo questions, and into one of the shorter buildings before taking an elevator to the third storey. Agbo's office was down a long corridor, almost to the end of the building. The hallway was odd, a dirty and dulled warmth to the paint that seeped into the air. As they walked along, it seemed as though they were bathed in soft glow sunset despite it being mid-day. When they reached the end of the hallway, they paused outside the door as he unlocked it, pushing it open and flipping on the light switch. The air conditioning unit had been turned off, so he asked them to wait at the door as quickly crossed the room, closed the windows and turned the unit on before gesturing them to come in.

The bulk of the room was painted a slightly lighter shade of yellow than the hallway, but there was one wall that was completely covered in bookshelves packed with books of all sorts including volumes that graced House's own bookshelves. Agbo's desk was a large 'L', the longer surface covered A3-sized papers with messy, typewritten letters upon them covering the rest of the desk. The chair behind the desk was well-worn with the ends of the armrests being a completely different colour than the rest. On the shorter side of the desk was a computer, and when Cuddy got close enough to see it, she saw a screensaver of photographs of Dr Agbo and a short, chubby light brown-haired Caucasian girl. She leaned forward, looking at the rather un-Ghanaian background of the photographs with a raised eyebrow.

'Please, sit,' he said, gesturing to the two brown faux leather chairs in front of his desk.

House and Cuddy took their seats, both dropping their bags between the seats and Cuddy switching her attention from the screensaver to Agbo himself as he gathered a file from his cabinets and walked behind his desk. Still standing, he dropped it open-faced onto the desk top and looked down, his fists on the surface of the desk. He flipped one of the pages over to look at a couple of notes, keeping the page held between his right index and middle fingers as he sat down in his chair. Nodding to himself, he leaned back and took his stethoscope from around his neck, contemplating it for a moment before setting it down on the desk next to the file.

'Do you have specific questions about the patient?'

'Just start talking,' House said. 'We have a dearth of information on this end, so surely you'll come up with something we haven't heard about yet.'

'Alright,' Agbo said, closing the file and folding his hands over it. 'Twenty-nine-year-old Caucasian female arrived by private vehicle to our acute care centre two weeks ago. She was unconscious but accompanied by her assistant Anna Cader, a nurse, who provided her history and present symptoms.'

Agbo pushed the file across the desk and House and Cuddy reached out at the same time to grab it -- Cuddy gave him an 'I'm the attending' look and he for whatever reason actually backed off.

'The only medically relevant history was seizures and depression,' Agbo continued. 'Cader also stated that cancer is relatively prevalent in the family -- lung cancer was the cause of death for both of her parents. A blood test on intake showed that she is HIV positive.'

'Her assistant didn't know that?' asked Cuddy, pressing her hands to the top of the file.

'She didn't appear to,' Agbo continued. 'And it wasn't long after that that she insisted on leaving and returning to Sumpini.'

'I wish we'd known that before we left the States,' Cuddy said with a hint of distaste, leaning back a bit in her chair.

'A huge drop in communication, I assure you,' Agbo replied. 'But it's worth noting that she was already aware of her HIV status. According to her, she's been HIV positive since she was twelve as a result of a blood transfusion given before Australia really screened their blood. She's an elite controller.'

'Australia?' House asked in an undertone, then looked at Cuddy and noticed she didn't even have the file open. After a very questioning glance, he held his hand out. 'Let me see the file.'

She hesitated and sighed before handing it to him. He glanced at the name and scoffed.

'Natalie Chase,' he said with a tone of disbelief. 'You've got to be kidding me. Who is she?'

'An Australian doctor. She works with Médecins Sans Frontières in Burkina Faso and Côte d'Ivoire but maintains a clinic in Sumpini. She moved here three years ago and actually worked here at KATH for two years before leaving to work in Damongo,' Agbo rattled off. 'She keeps a house in Damongo but is constantly traveling now that Cader is there.'

House waited a moment after he stopped the Alice-like chatter, then spoke. 'The reason I ask is that one of my employees is an Australian named Chase.'

Agbo raised his eyebrows. 'Is that so?'

'And this certainly explains why Cuddy was called,' he said, then turned to Cuddy. 'But doesn't explain why you didn't bother telling Chase about this.'

'I don't know what relation she is to him, but in case you've forgotten, when his father died, he killed a woman,' Cuddy said in a quick, snippy tone. 'Until we know something definite, I'd like to keep this off of his radar. When Dr Chase became ill, Dr Agbo called Princeton-Plainsboro and specifically asked not for Chase, but for you. The way he was talking, I'm not even sure he's aware there's an Australian named Chase on your --.'

'Cader specifically requested I call you, Dr House,' Agbo interrupted, trying to cut the tension that was clearly growing between a pained, belligerent House and an exhausted Cuddy. 'She did her Masters at Johns Hopkins and said that your being expelled was the greatest loss that Hopkins ever experienced. She didn't say a single thing about Chase having any living family, and considering that she lives with Chase, I think this is something that would have come up before. Regardless, she didn't ask me to speak to anyone besides you, Dr House.'

They sat in the humming near silence for a few moments before House looked over at Cuddy once more. 'But you weren't going to bring me.'

Cuddy returned the look. 'Because I figured it would hurt you too much to do all of the travel. Besides, I was going to call you if new symptoms came up.' She paused and gave him a dry look. 'It's not like you ever see or touch your patients anyway.'

House didn't grace her comment with a response, instead turning back to the file and opening it to flip through the pages. 'You said that you did a blood test that found her to be HIV positive, but there's no record of CD4 count being performed to determine her staging.'

'We use the iDiagnostics test here, so we only collected a drop of blood. When she woke up, we asked for her permission to do a CD4 count and CBC, but she refused,' Agbo replied. 'And if a patient tells me she doesn't want a test performed, I won't perform that test. When she came in here unconscious, Cader was able to act as a medical proxy and demand that tests be performed, but once Chase woke up, she started taking her treatment into her own hands.' Agbo shrugged. 'Unfortunately her choice was to leave against medical advice, but there's nothing that we can do when that happens.'

After a few minutes filled with House looking at the scant file for Natalie Chase, Agbo stood and switched off the air conditioner. Leaning over the desk, he held a hand out for the file and House gave it to him. After picking up his stethoscope and throwing it over the back of his neck, he walked to his file cabinet and dropped it in, closing and locking the drawer. Leaning over, Cuddy took both of their bags then stood. Agbo opened his windows once more then came around the desk, walking straight to the door where Cuddy was already standing. He leaned toward her and spoke in a lowered voice.

'It may not be my place to ask this, but I wonder if it would help at all if I could get you some intrathecal morphine for Dr House? He seems to be in a good deal of pain.'

'That would be absolutely wonderful for you to do,' Cuddy replied in an equally quiet voice, setting her hand on the doorknob. 'A lot of the time when he comes to me asking for something outlandish like that, I ignore it, but I think that this time he may actually be in pain.'

'If you take him down to the lobby, I'll head to the pharmacy and get you a vial and a makeshift administration kit,' Agbo said as Cuddy opened the door and walked into the hallway.

The three of them stood in the hallway as Agbo closed and locked the door. The sounds of the elevator chiming on another floor and those ever-present hospital noises echoed in the distance as the lock clicked. Agbo turned toward them.

'I'll get what you need and then take you to a taxi,' Agbo said as he dropped his keys into his pocket. 'One of the most annoying things about Ghana has to be people ripping off foreigners. They even did it to me when I first came back to Ghana from America.'

They started walking to the elevator, their shoes tapping hollowly on the poured floor. Cuddy spoke. 'How long were you in America?'

Agbo laughed shortly. 'A long time. Twelve years. I started as an exchange student and then stayed there for college and medical school.'

'Oh? Where did you stay?' asked Cuddy and House groaned, obviously not at all interested in this kind of personal conversation taking place.

'New Hampshire. I attended the same Catholic school that Cader attended, though she was three years behind me,' he said, looking over at Cuddy as they stopped in front of the elevator. 'The Caders were the ones who sponsored me.'

'No wonder you were so willing to call in an outside party for something so obvious as diagnosing an elite controller as no longer being in control,' House grumbled as he stepped into the elevator and leaned against the wall.

Agbo just smiled lightly at him as he followed the two of them into the elevator. 'I wanted to return to Ghana and become an engineer, but Anna's father Dr Cader got me very interested in biology. He's the head of the biology department at my alma mater, Saint Anselm.'

Agbo pushed the button to take them down to the lobby, looking down at his watch for just a moment. When the doors opened at the ground floor, Agbo stepped out and House followed, Cuddy watching him with concern as he did so. They walked into the lobby proper and what had been an echo of movement and conversation became a bit of a roar. During their meeting, a new group of Westerners had appeared and was very obviously being oriented to the place, all of them seeming a bit taken aback by the relative modernity of the hospital. A couple seemed to recognise House, pointing and whispering amongst themselves, but they were obviously smart enough to know he wasn't to be approached. Even though he knew the people following him, he still tensed up as though someone unwelcome was coming up to him when Cuddy reached out and took his elbow into her hand. She walked along side him and spoke in a low tone.

'Dr Agbo has gone to get some Duramorph for you, House,' Cuddy said, and House looked relieved for a moment. 'When we get to the hotel, I'll inject it because I have a feeling you don't want to have to hang around here for awhile.'

House nodded.

'We're just going to sit outside for awhile and he'll bring it to us, then we can go back to the hotel and you can lie down for a bit.'

'Yes, Mommy,' he replied as they walked out the door.

Ten minutes later, Dr Agbo appeared in front of the bench where they were sitting with a bag containing individually packaged items and ampoules of morphine and tetracaine. Cuddy took the items from him and stood, watching in silence as Agbo walked to a dingy-looking red car that had just let a woman and small child out in front of the hospital. He chatted in low tones to the driver before gesturing to them and handing the driver two pink Ghana cedi bills. House opened the door and slid in the back seat, leaning against the half-way jammed window on the other side as Cuddy sat down beside him and closed the door. The window on her side slid down into the door when she slammed the door closed, but the two Ghanaians didn't seem to notice. Agbo leaned in the back window and looked at both of them.

'The driver will take you directly to Hotel Georgia,' Agbo said. 'He's been paid a price we agreed on and that is all he'll be taking. Do not let him tell you that you owe him more money.'

'We won't,' House said moving his cane from beside his leg to between both of his legs. He tapped his fingers on both sides before looking out the window once more.

'You've been very helpful and I hope we can do something for Dr Chase,' Cuddy said, reaching up to take his hand again and shake it.

'Give my regards to Annie,' Agbo said, then said something to the driver. The man stared up the engine. 'I hope you'll stop by again before you leave the country.'

'We'll try,' Cuddy said as he stepped back from the car and they began driving off.


	8. Chapter 7

When they got to the hotel, most of the gaggle of girls had for whatever reason decided to go out and view a bit of Kumasi. They took dinner at a table by the pool at the hotel with Judith, the sole American, and she offered little conversation, explicitly stating at one point that she had no interest in meddling at all in their business. The only personal information they got from her was that she was Judith Newsome, a nineteen-year-old freshman education major at Middlebury. Despite spending half of the day sleeping on the trotro, she was still exhausted and admitted that she had malaria but was unwilling to cancel her trip to Mole for something she was already being treated for. After walking with them to the stairs following dinner, she told them she would see them in the morning and disappeared into the half-lit marble stairwell. By the time the lift got House and Cuddy to their floor, Judith had already gone into her room.

Their room was absolutely frigid, something which was both welcome and unwelcome. House sat down on the edge of the bed as Cuddy went to draw a bath for him. When she disappeared into the bathroom, he started undressing and was down to his boxers when Cuddy leaned back out of the room.

'The water's not heating.'

'Is the water heater turned on?' he asked in a frighteningly quiet voice.

'Yes,' she responded in a perhaps too measured tone. Realising the connotation behind that timbre, she continued. 'The red light is on, the water is running, but it's just not heating up.'

He closed his eyes and nodded, licking his lips a bit as he grabbed at his leg. Only a moment passed before Cuddy remembered that the silence that came over House in the depths of pain seemed nearly as torturous to her as it was to him. It wasn't something that she experienced often but if it was bad enough, it transported her to the days before his surgery. She turned away from him, going back to turn off the water before leaning against the door frame and looking at him hunched over.

'We could just go right for the Duramorph,' she offered.

He was silent for a few painful moments, then looked up enough that the light changed and she could see sweat on his brow. 'I'd like to at least have some warm towels.'

She nodded vigourously, leaving the door frame and walking to the hotel room door quickly enough that had they had their luggage, she could have pulled it along with her in the gust of movement she created. After assuring that the key was in her pocket, she walked to the stairs and almost skipped down them. She hit the marble lobby floor three flights later and made an immediate left turn to go to the front desk.

It was very rarely that Cuddy saw a front desk that actually had a tap bell on it, so when she came in the front door of the lobby, she was a bit confused by both the absence of an attendant and the presence of the bell that she didn't recall seeing earlier that day. Leaning over the desk, she looked both directions behind it before hesitatingly reaching out and tapping the bell once. Before the sound had faded, a man came out from the office with a wide smile on his face.

'How may I help you?'

'Hi, I'm staying in 3...' she thought about it for a moment before shaking her head. 'In the last room on the right on the third floor. Our hot water isn't working.'

'Yes.'

Cuddy raised an eyebrow. 'We need hot water.'

'It's not working now.'

Cuddy slowly set her palms on the countertop, letting out a sigh through her nose. 'The man I'm with has a pain problem and really needs to be able to soak his leg.'

The man's smile dimmed a bit. 'I can get the kitchen to boil some towels for you.'

He began flipping through the guest book; leaning against the countertop, Cuddy watched him quietly before pointing. 'Lisa Cuddy.'

Mouthing to himself, the man scribbled a note on a piece of paper before looking back up at her. 'We'll send them up shortly.'

'Thank you,' she replied then walked back from whence she came.

The stairwell was dark, so she had to watch each marble step carefully -- somehow earlier she just hadn't noticed the dimness of the light or for whatever reason didn't consider falling down as worthy of caution as the current danger of falling up. On the third floor, she did another left turn and walked to the very end of the hallway before pulling her key out and unlocking the door.

When she first walked in, she was nearly convinced that House, who was now laying on the bed in the foetal position, was dead until he let out a meek little moan. After closing the door quietly behind her as though House was simply suffering from a headache, she went to the nightstand and opened the bag, pulling out a chuck and unfolding it onto the wood surface. Looking inside of the bag, she dropped out a needle for the local anaesthetic, a set of three povidone iodine swabs, a sterile drape that she really had no intention of using, an introducer needle, a spinal needle and finally the syringe to be used to administer the analgesic. When everything was laid out, she bent over and pulled the bin to the side of the bed.

'I need you to curl up a little tighter, House,' she said in a faraway tone then waited several seconds for him to speak. 'Do you need help?'

'Did you get towels?' he finally asked quietly.

'They'll be sending them up,' she replied as she opened the pack of iodine swabs.

Without responding, House completely rolled into himself, a pillow held to his chest. Once he seemed vaguely settled, Cuddy laid another chuck right behind his back before she gloved up and prepared the local, setting the filled needle down on the chuck before filling the larger syringe with the morphine. Looking between him and the nightstand, Cuddy sighed, having the feeling that this was a rather shady place to be entering the spinal canal. Picking up the swab package with her left hand, she prepared the skin around the injection area with her right, dropping used iodine swabs into the bin until all three had been spent. As the area dried, she picked up the needle containing the local with her left hand. After feeling the spaces between his vertebrae, she landed on one location and stopped, poising the needle over the skin.

'I'm now going to anaesthetise the general area.'

House laughed a bit. 'Really, I don't need the play-by-play.'

She smiled a bit before piercing into the skin and slowly injecting the local in both skin and deeper tissues.

'I probably wouldn't even care if you just jammed the Duramorph straight in without any anaesthesia.'

'How hardcore,' Cuddy replied dryly as she flipped the safety cap on the local needle.

Reaching over to the table, she picked up the introducer needle, its safety top slipping smoothly off to remain atop the nightstand chuck. After assuring she was in the right place, she pushed the large needle right through the skin and into the spinal interspace she was aiming for, letting out a relieved breath when she didn't encounter any resistance. It stayed in place as she grabbed the final preparation component for the spinal, the aptly named spinal needle. After pulling it from the loosened safety cap, she slipped it into the introducer needle and into the subarachnoid space, holding it there for a moment then pulling out the inner needle and dropping it on the chuck behind House. As her left hand grabbed the syringe of morphine and the right a patch of gauze, she watched spinal fluid drip-drop onto the chuck with a bit of a grimace.

'I don't care how many times I perform or watch one of these,' she said, holding the needle steady with the gauze held around it as she attached the syringe into it. 'That dripping is still pretty disgusting.'

She pulled back on the plunger to aspirate for blood then injected the bolus. Once it had all been injected, she pulled the entire contraption out at once, pressing the gauze where the introducer needle had punctured the skin. With her hand still holding the gauze, she folded up the chuck on the nightstand, containing all of the items within it, and dropped it into the bin. As she pulled the chuck from behind House, she lifted the gauze for a moment and was pleased to see no horrible spurting of blood and various other bodily fluids.

'Looks good,' she said to him as she grabbed the square of gauze into her palm and pulled the glove off around it then put the glove in the other hand and pulled that glove off to make a little glove baggie. 'Lay just like that for a bit.'

'You actually think I want to move?'

Cuddy assured that all of the surfaces used were clean then took the last item from the bag Agbo had given them: a bright red biohazard bag. She poured the contents of the bin into it and was in the process of tying the top when there was a knock at the door. Cuddy stood and started toward the door with the bag in her hands. When she got to the door, she dropped the bag right next to it.

'Who is it?' she asked with her hand already on the knob.

'The front desk,' a voice replied from the other side. 'I brought the hot towels you need.'

'Wonderful,' Cuddy said as she opened the door and held her hands out for the random warming tray full of towels that was offered to her. 'Thank you so much.'

As soon as the door closed, Cuddy walked back over to the side of the bed and set the warming tray on the nightstand. She took the top off of it and relished the gust of steam that rose to her face. Grabbing one, she washed her hands and face then threw the spent towel into the bathroom.

'Do you just want me to lay one of the towels on your leg?'

'Whatever,' he said in a faraway, relaxed tone.

She unrolled one of the towels and then folded it into a square before placing it atop his leg. After a moment, he reached up and pressed it hard to the skin. Cuddy peeked once more at the injection site and feeling as though it was a little exposed to the elements, she walked to her purse and pulled out a rather battered-looking plaster, peeling the outside wrapper off and then walking back to paste it onto his back, the pad pressing to the place where the needle had sat. Confident of a job well done, she moved around to the other side of the bed and sat down next to him. Leaning back against the headboard, she sighed and closed her eyes.

'Do you think you'll be okay?

'Already feeling better,' he replied, his voice muffled to the pillow. 'Thank you.'

Cuddy raised an eyebrow but didn't bother opening her eyes.

'So,' House said. 'Do you really not know anything about this Natalie woman's relation to Chase?'

'It's not exactly a thing mentioned in a Google search.'

'You Googled her?' he asked, moving his face up a bit to rest his chin on the upper edge of the pillow. 'How next generation.'

'She graduated from the University of Newcastle with specialties in pharmacoepidemiology and communicable disease epidemiology.'

'Ah, communicable disease epidemiology,' he said with a drawn-out tone. 'Indeed helpful in the land of malaria and leishmaniasis... and giardia... and trypanosomiasis... and--'

She reached out blindly and put a hand over his mouth. 'I get it, House. Africa is a dirty place with horrible, no, absolutely mortifying diseases.'

He licked her hand and she pulled it away, finally bothering to open her eyes and look at it as she held it by the wrist with a scrunched up face.

'Mature.'

'I've always been an absolute master at maturity,' he slurred.

He yawned into the pillow, so she took the hint and leaned over, pulling the towel off of his leg and throwing it in the general direction of the bathroom -- it made it only about three feet before slapping to the floor. When she started pulling at the sheets, House finally moved and helped her pull them over both of them. Cuddy pulled them even farther up until the sheets hit House right at his chin. He nuzzled the pillow before lifting his head and shoving the pillow under it. She looked at him for a moment before turning away and flipping off the light. Within a minute or so, she'd repositioned herself and the only sound became the whirr of the air conditioning -- apparently the only slight disparity between the populations of Accra and Kumasi greatly increased the silence experienced at night. After a few minutes, the sheets rustled once again and an already-sleeping House curled up against her; she sighed but didn't move away.


	9. Chapter 8

Morning started moderately late. House and Cuddy were woken up at nine by Phyllis, the woman who was old apparently old enough to be the mother of all of the girls -- the night before, Phyllis had been kind enough to purchase a simple dress for Cuddy and an old t-shirt for House. After a quick breakfast that included a delightful lack of Vicodin-taking on House's part, they all loaded into the van and headed out of the city. Once highway became the wide rule rather than narrow exception, the speed of their shady vehicle steadily increased. They sailed along the highway driving cringingly close to other vehicles at approximately five-eighths the speed of light and in towns, rather than slowing down, they'd just honk and keep going at the same breakneck pace. Very soon after leaving Kumasi, they'd passed directly and deeply into the sticks, finally entering mud hut territory a couple of labeled villages outside of Techiwan.

Every road sign in Ghana looked the same. Black on white, black on white, every sign ringed by black. Even the smallest areas were labeled with names like Jato Akumaa and Dawadawa. Although House and Cuddy started out sitting right next to each other, after a quick stop at a convenience store to pick up booze and plantain crisps, there was some sort of Chinese fire drill which ended in House and Cuddy in possession of three seats instead of two. House was pleased by the extra room but unhappy that the chatty Alice firmly planted herself behind him and kept poking him in the hopes of picking up conversation, offering up such inane geographical topics as how flat this area of the country was in comparison to the eastern part, how there were so few but much taller baobob trees, how the grassland was rather nice to create a smoother highway, et cetera. As an escape, House pulled his sunglasses and iPod out of his bag and leaned back, kicking his legs up onto the seat. When he woke up however long later, there was mysteriously another Ghanaian man seated up in the front with the driver and tour guide. House looked over at Cuddy questioningly, poking at her with his toe until she spoke.

'He was picked up outside of this place called Bawa Akumaa,' Cuddy said, stressing the last 'ahhhh'. 'None of us have a clue who he is, but he has proven correct the theory of three people fitting in the front seat.'

'Girls, it's about ten kilometres until we get to Buipe,' Phyllis said.

House was about to reply with something to the effect of 'where the hell is Buipe and why should I care' when they hit a massive pothole. Cuddy, sitting on the jump seat at the end of House's bench, popped over and across onto his legs as her seat tried to fold back in. Gemma, sleeping sitting up in the back between Lydia and Alice, flew up and jammed her head into the ceiling, waking up to look at all of them then turn around to look out of the back window. A moment later, she turned back with wide eyes.

'I think something might have just fallen off of the trotro,' she slurred exhaustedly but fearfully.

They started climbing a hill and Phyllis leaned forward to look at the driver press the clutch and attempt to take the van out of fifth. It whirred in neutral for a minute during which the guide and driver had a heated conversation, the random guy and Posse watching them. Cuddy looked at House with concern before the vehicle shifted and both them and the girls around them visibly relaxing for a few minutes until the driver suddenly swerved to the side and pulled over, throwing open his door and sliding out. They all waited, watching the driver open the bonnet and tinker around before he yelled in to the tour guide. The guide responded very tensely before falling silent.

'Do we need to get out?' asked Phyllis, leaning forward to the guide.

'That would probably be a good idea.'

House had to admit that with the van at a standstill, the heat was very rapidly increasing inside of the vehicle, so it felt wonderful when he stepped out after three of the girls and Cuddy. As Judith got out, she grabbed House's cane from under their bench, handing it out to him so that he could walk away from the road. Passing cars and lorries rushed air at them as they walked over to a little palm frond-covered area where women were selling piles of bananas and bags of groundnuts. As the girls bought fruit and ice water from school-age children proclaiming they were selling 'pure water' in sachets, House and Cuddy stood in the shade next to a pile of mangoes and watched the driver and his associates appear to do nothing even vaguely resembling fixing the trotro.

'It's something about the vehicles here, I swear,' Cuddy growled, and House looked over at her. 'Any time we get in one of those damn things, something horrible happens.'

House chuckled and raised an eyebrow as the tour guide breezed from the van to Phyllis, who was smelling a pineapple. She paused, her nose still against the spiky skin of the fruit as she listened to the guide speak. There was a little fight between then that led to the girls wandering over to their fearless leader. When they got the gist of what was going on, they started making loud exclamations about how much they had paid for the trip, what a massive bother everything had been so far, how he was a completely useless tour guide, et cetera before all stormed toward the van. Gemma started toward the vehicle before remembering their tagalongs and turning around to walk to them, grabbing House's wrist and pulling him toward her.

'Get in the van.'

'Whoa,' House blurted out, and in an almost instinctive move, Cuddy struck out and took his other wrist.

'I'm not taking him hostage,' Gemma said in a very insolent tone, something that seemed very much out of character for her. 'That _fucking_ guide, he says we have to push the van to get it going and I have a feeling you won't be wanting to run after a van because of your leg.'

With a slight nod, House gave in and allowed Gemma to pull him along to the van. He crawled into his place near the window on the third row. After a short conversation with everyone, Phyllis got into the van in the very front left window seat and Judith got into the second-row seat between Phyllis and House. In an... unexpected? turn of events, every Ghanaian included in the trip got into the trotro. Phyllis gave Posse an scandalised look as he audaciously sat on the jump seat at the end of her bench. At the back of the van, Sarah was laughing nervously as Alice, Gemma, Cuddy and Maggie pressed their hands against the dirty boot. Lydia pulled Sarah toward the others, putting her hands next to her own as they prepared to push. The driver turned the ignition. With a few grunts and gripes, the girls began pushing the van up the hill, all screaming both for the top to come so they could jump in _and_ reminding passing, honking lorry drivers that they did, in fact, know that they were white women, oh wow, how exciting. When the hill finally crowned, everyone began sprinting, each trying to catch up and dive into the van. First Alice, then Sarah, the Lydia, then Cuddy, then Gemma and finally Maggie, all glaring at Posse, the tour guide and the completely random hitchhiker that no one wanted to be there.

They festered in silence, the girls shifting their things around and grumbling, but it was something that Phyllis said that started spoken discord.

'Oh come on,' Phyllis began, and all of the girls stood at attention. 'The _speedometer's_ not working!'

The girls around them tensed and House and Cuddy looked at each other rather nervously.

'That is okay,' the guide replied and negative sounds started coming from the girls.

'No, it's not,' countered Phyllis, reassuming her 'mother of the group' position. 'Either we get a new van in Buipe or we'll gladly find another mode of transportation without you.'

'Or your posse,' Judith murmured. 'And your drug dealings.'

'Why can't we touch our own luggage?' Lydia yelled from the back. 'Are you hiding something back there we can't know about?'

'You realise that we're all foreign citizens and really get screwed if the police find whatever you're hiding, right?' Maggie asked, yelling it right by Posse's ear as he was the one who always seemed to hover near their luggage.

There was an explosion of human sound as all of the girls started talking at once. House and Cuddy said nothing. Phyllis let it go on for a moment, looking back at her age contemporaries before rolling her eyes and speaking.

'Okay girls, enough!' she said and all of them stopped talking rather quickly. 'We get a new trotro in Buipe, _e_?'

'_E_,' the guide replied. 'We'll get a new van in Buipe.'

As soon as he spoke, the van jolted as they swerved around a lorry, nearly losing a game of chicken to an oncoming taxi.

'My parents told me I was going to die here,' Sarah said breathily, leaning forward to grab House's seat. 'They said it was going to be from a disease, some horrible disease, and I thought I would die from not ironing my clothes, but I'm going to die in a car accident and there will be goats and--'

House turned around and glared at her. 'I _will_ kill you.'

Alice leaned down and grabbed her backpack from the floor, digging out a few salad dressing-sized sachets of liquor and holding them toward Sarah. Sarah considered them and picked out a whisky called Black Punch, gnawing a corner off of the pouch and then sucking at it like her life depended on it. After that, things quieted down and House once again reclined, his feet pressed up to Cuddy's hip. She allowed it for only a moment before taking her left hand and shoving his legs off of the bench. In response, he bent his legs and gave her an extra six inches of space between the two of them. She gave his feet a sideways look before going back to reading a short book that Phyllis had given her.

Silence gave House time to contemplate his surroundings. He stared past Cuddy, watching as they passed a myriad of perhaps stereotypical African scenes. Now that they were outside of most of the larger cities in the area, there were starting to be real mud houses, most covered in tin roofs but an increasing percentage with thatch, something which seemed very odd considering the absolutely pristine highway they were hazarding along. Wherever there were groups of houses, there were tall piles of mysterious burlap bags holding coal and hay, and in places that were seemingly abandoned, there were freshly painted advertisements for Key soap and Hacks cough drops on building sides. Another common sight, House noted with a raised eyebrow, was rusted-out cars.

'Does it even rain enough here to rust cars?' Cuddy asked, and he focused on her mouth before looking beyond at yet another rusted car.

'Are you reading my mind?'

She ignored him, instead continuing to look outside.

'Good Lord, look at the size of those ant hills,' she murmured as she looked out the window at massive, multi-towered dirt colonies lined one after another.

'Termite hills,' replied Maggie from in front of Cuddy; she hadn't even bothered to look up from her five-month-old tabloid magazine.

'Termite... hills,' Cuddy repeated hesitatingly.

'Huge flying termites,' Alice said excitedly from behind House. 'When it rains, they all come out and head toward anything even vaguely light -- they'll absolutely cover a house, and when you step on them, smash them, whatever, they look like they're filled with pus! One of our neighbours says they taste wonderful, and whenever it rains, he puts out a big thing of water to catch them and after they drown he eats them like crisps!'

Cuddy stared blankly at the back of Maggie's head as House furrowed his brow.

'I'd never eat them,' continued Alice quite matter-of-factly.

'Good to know,' replied House as they finally passed the little black-and-white sign welcoming them to the outskirts of Buipe.

As far as House could tell from a distance, Buipe definitely had a motley array of buildings, most with rusty tin roofs and old-fashioned aerials held up on insanely long poles. They crossed a bridge that took them over the Black Volta -- amidst the refuse piles next to the river, people were using the water for doing their laundry as their truant children joined by a troupe of chickens played _in_ the garbage. Several women walked away from the river with large metal bowls atop their head; Cuddy knew at that moment that she could not look House in the face because doing so would make him aware that she was thinking about the copious amounts of bacteria and protozoa that were found in that water thus giving him an opening to bitch about African hygiene or the lack thereof. Cuddy instead focused in on the fact that the water the women chose was being collected downstream from people bathing. With a sigh, she pressed her head against the window.

Five minutes later, screeching tyres announced their arrival at the first filling station in the city. The moment the trotro stopped, all of them quickly piled out as though the van was going to explode. The tour guide got out much more calmly, immediately pulling Phyllis out to the side and talking to her in hushed tones. As they discussed whatever they were discussing, the Africa-jaded girls and House all stood around looking rather bored. Cuddy, however, was much more interested in the goings-on in the moderately minor provincial town. She walked a bit closer to the road, looking across the way at a makeshift market that had formed. A halfway screened-in stall sold lunch food, and even from where she was standing, Cuddy could see the flies all dive-bombing the piles of rice, each being held from its target by only an absolutely ancient-looking woman waving a fan in the rice's general direction. There were more fruits for sale, a man with a curled up armadillo hanging by its tail from his arm, a table full of shady bottles of cooking oil...

She wasn't at all paying attention to anything else when House walked up to her slowly, holding out her purse.

'Cuddy,' he said, and she looked away from the lorry that had just passed, one that happened to have a tied-up live goat perched atop it, before taking her purse. 'As the van's getting fixed, we're gonna just go sit in a restaurant or something. The tour guide's getting a taxi for me -- the girls are just walking there.'

'I'll stay with you.'

'I figured you would.'

They went silent again, Cuddy crossing her arms and staring straight off into space as House looked up at the increasingly angry-looking sky. A trotro passed and House looked after it pensively.

'Despite the recent weather,' House started. 'Was it a dry year here?'

Cuddy looked over at him with a raised eyebrow. 'Random.'

'Just taking an idea of Foreman's and running with it.'

'What a novel idea!' Cudy chaffed. 'I guess paying their salaries is finally worth it.'

'That trotro that just passed, the one with the goat on it,' House said, jabbing his thumb in the general direction that the trotro had headed. 'It was full of cassava, not people.'

'Cassava,' Cuddy repeated. 'The poisonous root vegetable?'

'Let me guess -- you heard it from Dr Charles?'

'You know, I'm allowed to have random knowledge on my own,' she snapped back. 'And it _has_ been a dry year in the region, but I don't think it's TAN.'

'Is this going to be another time where you let me know some important tidbit you were holding back about the enigmatic Natalie Chase?'

'The woman has lived here for more than three years, lives in a small village where she probably has to prepare her own food, has a Western medical education but worked in a Ghanaian hospital seeing their local maladies for a couple of years and you think that she's stupid enough to forget to soak cassava for the proper amount of time before eating it?'

'All are idiots until they prove otherwise,' he replied.

'Let's just hold back on the differential until we meet her,' Cuddy said, reaching out to pull the strap of his backpack higher on his shoulder. 'I think we've guessed just about as much as we can without doing a physical assessment.'

They went quiet one last time as scattered drops of rain began pattering on the dirty road, creating little muddy circles all around them. Cuddy raised her purse over her head just as a taxi finally pulled over to the waving tour guide. He leaned in and talked to the driver just as Dr Agbo did, but when they got over there, he informed them that the driver would figure his own tab once he dropped them at the restaurant. Resigned due to the rain, they both just got into the cab without a fight.

---

It was _really_ raining by the time they got to the restaurant. Despite the darkness accompanying the rain, the owners didn't seem to think they needed more than a couple of awkwardly-placed fluorescent bulbs to compensate. Sitting in the very centre of the restaurant on the edge of an unnatural light ring, six out of their seven co-travelers sat, their bags piled atop another table in the almost empty restaurant. In one corner, an ancient television blared -- in very lovely mono -- some Sin City-esque music video; according to the jumpy title at the bottom, it was called 'Throw It on Me'. House stared at it for a minute, trying to discern what was static and what was hot girl-on-girl action, but to no avail. The look on Judith's face as she stared glaze-eyed at the screen almost made it seem like she was watching a philosophy professor speaking during a four-hour lecture -- in the back of his mind, House wondered if she was looking for the same thing that he was. Cuddy walked over to the luggage table and set her purse and House's backpack down, pulling out a velvet sachet; she was in the process of sitting down when Maggie came from a door in the back.

'In the loo, there's no bog paper,' she whispered harshly to the table. 'There's _newspaper._'

'News_print_ you mean?' asked Phyllis, fully prepared for a semantics battle to protect her delicate sensibilities.

'No,' continued Maggie, thrusting a handful of a newspaper at the table. 'News_paper_.'

'Lovely,' House said distastefully.

Maggie dropped the handful of newspaper onto the table -- House, in response, scooted away from it -- and almost immediately, Lydia reached out and grabbed it, flipping through it to read the likely weeks-old Ghanaian news. A waitress walked up and set a plate of jollof rice in front of Phyllis and a cup of rice before Alice then smiled, coming around to the newly-arrived House and Cuddy.

'I can get you something?' she asked awkwardly.

'Tropical Fanta,' House replied, still unwilling to get closer to the table.

'Nothing, thanks,' said Cuddy, watching as Gemma thumped a fresh pack of playing cards on the tabletop.

There was the delightful whirr of cards shuffling and House finally ballsed up and got closer to the table, tapping the wood so that Gemma would deal him in. As the first card hit his fingers, lightning struck and the power unsurprisingly went out, dropping them into darkness as a surprisingly cold wind blew through the front doors causing rain to splatter in -- fortunately, a set of ceiling-to-floor completely ghetto curtains held the great majority of the rain back from the group. Everything was in stasis until Maggie pulled out a large torch and set it on the table, pulling up the handle on it to turn it into a lantern. When the light was good enough, Gemma continued dealing the cards and they all settled into playing poker.

'If you don't mind me asking, why are you and Dr House going up to Damongo?' Phyllis asked before taking a bite of the spicy red rice and chicken mixture in front of her.

'I don't mind at all,' Cuddy replied as she pulled a UV pen from the velvet sachet she'd grabbed earlier. 'Dr House is a very talented diagnostician, so he's here to help me diagnose a very ill Australian doctor who works at a clinic near Damongo.'

Cuddy dropped the UV pen into the glass of water in front of her and watched as the bluish light turned on. She stirred the glass of water until the light switched off, then pulled it out and shook off the excess liquid before setting it on its sachet atop the table.

'I was supposed to be coming alone, but he sort of hijacked the trip,' she said in a low voice, sounding a bit resigned. 'I guess now I'm just here to keep him from insulting people too much.'

Phyllis smiled at her then took a couple more bites of her rice. 'It seems like he enjoys torturing you.'

Cuddy laughed a bit. 'To say the least.'

'It's like he's curmudgeonly and insanely childish rolled into one package.'

'That's a nice way to put it,' Cuddy murmured as she picked up her glass of water.

There was a loud growling as the generator came on. After a few weak flickers, the lights came back on, but it was so dim that Maggie kept her torch open.


	10. Chapter 9

It was a very-much-longer-feeling four hours later when the tour guide finally showed up again acting like a much of a hassle as he had been earlier except _this_ time he was kind enough to be claiming that the broken van was, in fact, perfectly all right and that they would be using it to get to Mole. There was a huge outcry amongst the travelers but they soon realised that they really had absolutely no choice in the matter. Defeated, they all piled back into the van, Sarah doing that same nervous little laugh once more for a good five minutes after they got underway. It apparently didn't bother Alice this time or perhaps she only liquored Sarah up after a good House outburst, so there was no silent offering of awkward packets of jail toilet-grade alcohol. Bothered but exhausted, House reached into his pocket and grabbed a Vicodin, leaning over the seat to grab Sarah's hand and place it squarely into her palm. After she dry swallowed it then drank a Crystal Light chaser, he turned back with his arms crossed over his chest.

When Cuddy offered a quiet compliment for the gesture, House replied that it was either that or kill her.

The weather had managed to clear off so they were able to see that the sky was really starting to get dim when they got out of Buipe. After the long wait in the restaurant, time seemed relative, leading them to believe that basically right after they left Buipe, they'd been magically transported to Serkyekura where the once pristine highway began becoming bumpy. There was much to look forward to according to Phyllis -- she'd been up in the region before and promised them that once they reached a place called Fufuitso, their lives would quickly become a living hell. When the little sign announcing their arrival in said village appeared, Cuddy felt her stomach drop, and House's soon joined hers when they made a sharp left. When the first van-sized pothole was hit, shooting dust up to some obscene height, they all realised that soon they would indeed want to die.

After about a half-hour on the unsurfaced, red dust road during which they traveled maybe ten miles, they finally came upon a quite stereotypical African village which consisted of a handful of circular mud huts covered with thatch roofs arranged around a central, communal fire ring. As they drove by, children in various states of undress ran toward the road, all of them shouting excitedly as the girls wave out at them. Maggie attempted to take photographs of them, but the van was moving so awkwardly and the light was so poor that the photographs ended up just being spectacular blurs of flash-bleached faces. By the time they made it to their first marked village, Janukra, the sun had already completely set and the villages where children once screamed happily at the obruni became nothing but sleepy little settlements with mosquito-repelling communal fires and individual citronella candles set into window holes, their light brightening the cotton curtains that sat behind them.

'It smells deceptively like marijuana,' House said after awhile, his first real vocalised thought since starting down this road from hell.

Cuddy sniffed the air then nodded.

'There's nothing deceptive about it,' Judith said, turning around to look at him. 'Marijuana may be illegal here, but they still manage to have some of the finest ganja around and many people partake.'

'You sound enamored,' House replied. 'Are you sure you don't go to Bennington?'

Judith laughed the moment before they hit a huge pothole. They slowed down in an attempt to calm the shock absorbers, and once they stopped shuddering, they were off again. Motorbikes and Land Rovers passed them at breakneck speeds, all seemingly unfazed by the extremely questionable road. By Kojope, Judith and Sarah were hanging out of the windows and looking up at the pitch-black sky and the unbelievable amount of stars swept across it. Sarah slipped her head back in to announce this natural wonder to her contemporaries.

'It's even darker here that in Hohoe,' Sarah said in quiet, amazed tone before leaning back out of the window.

Phyllis glanced out of her window as Gemma and Maggie leaned out of their windows. Judith continued leaning out the farthest, her mid-back hitting the window frame as she hung out to look at the sky. After looking at the girls, Cuddy pulled the window a bit so that she and Maggie could hang out together, both absorbing the beauty of the stunningly clear sky. House didn't even bother looking, instead keeping his eyes out for the red-and-blue elephant signs that had replaced those black-and-white ones that he'd grown accustomed to on the highway. As the next one was illuminated by the headlights, House reached over Judith to poke Phyllis. She turned around.

'Sumpini,' said House, pointing at the sign put up by the National Patriotic Party that welcomed them to an area that was, at its very best, a hamlet.

'What?' asked Judith, pulling back into the van.

'Sumpini, the place where Cuddy and I have to get out,' House replied, perhaps a bit sharply as though the location where they were headed should have, at this point, been imbedded in the girls' minds.

'Hey, turn there,' Phyllis said to the tour guide, pointing to an empty area in front of a concrete building.

The tour guide said the same thing in Ewe to the driver and the man turned off of the road, stopping in front of the unlit building. Once they'd stopped completely, he turned on the cabin lights so that House and Cuddy could see their things. Posse got out and turned around before rolling the door open for them and watching as they stepped down onto the dust. Outside, it was black as pitch, the only lights coming from the van and the centres of little homesteads where the now-familiar mosquito-deflecting fires and candles burnt. Nothing moved -- no human, no monkey, no nothing. After a few seconds, Maggie pulled out her torch and shined it in the direction of the one concrete building. There was a sudden sound akin to twigs being stepped on, but other than that, nothing happened.

'Do you really think this is the place?' asked House from beside Cuddy as they stood looking between the houses and the concrete building with the girls squirming in the van behind them, obviously wanting to get on so they could go to sleep -- Cuddy couldn't blame them.

Cuddy was about to say something when to short, lanky forms appeared out of the darkness accompanied by a series of light tapping noises. Without any warning, they began running down the stairs of the building as fast as possible. The girls noticed them too, suddenly murmuring to Cuddy and House to get back into the van, but they ignored them, House squinting into the darkness. The forms bounded into the light, one of them jumping directly up at House, who grunted as he was pushed against the van.

'Ah!' exclaimed Gemma, moving forward from the back seat to grab the ear of the dog that had propped herself against House. 'English Setters!'

The other dog, his surprise attack foiled by his contemporary, walked up to Cuddy and sat, looking up at her expectantly. Cuddy squatted down and scratched his head and he leaned against her.

'Considering every other dog in the entire country is a Basenji,' began House, rubbing the dog's head. 'I'm going to assume that we're in the right place unless the people in the huts over there have been importing purebreds.'

'Baring! Martin!' came a female voice from the concrete building, and they looked up in time to see the light in the foyer of the building turn on. The woman appeared, an unlit flashlight in her hand, and paused, putting a hand over her mouth as she began down the stairs. 'Oh no, did they get in your way?'

'We'd already stopped,' said Cuddy, standing up.

'Oh, thank God. Sometimes they run out and chase cars,' the woman said in an exasperated voice. 'You know, you two, just because your lady's away doesn't automatically give you permission to be bad.'

She made it all the way down the stairs before the dogs both ran to her, whining and jumping at her. She shushed them and scolded them quietly before telling them to sit and stay, at which point she got into the halo of light around the van.

'Is something wrong? Do you need help?' she asked, standing next to Cuddy as she looked into the van.

'No, they were just letting us out,' said House as he stood up, brushing the dirt from the dog off of him.

The woman looked down and gasped. 'Dr Gregory House!'

She did an odd little dance as House stared at her.

'When I asked Kwame to call Princeton-Plainsboro, I just thought that he might be able to tell you about Natalie and you'd call with advice or something, not that you'd actually come!' she said very quickly, then held her hand out. 'Anna Cader.'

He raised his eyebrows and awkwardly held his hand out to shake hers before pointing behind her with his other hand. 'Dr Cuddy's the one who brought me along on this one.'

Anna turned around and House took this moment to roll his eyes at Cuddy. Cuddy's eyes flashed danger to him before she smiled at Anna and shook her hand.

'Thank you for making him come, Dr Cuddy.'

'No...' she began, and Anna turned away, moving to the passenger side window of the van. '... problem?'

'_Me ma wo adwo. Wufri hε?_' Anna asked the hitchhiker.

Once the hitchhiker responded with the word 'Kumasi', they started up a conversation and were soon joined by the guide, the driver and finally Posse. It turned into an uproarious discussion, all of them laughing as they spoke. House moved to Cuddy and stood beside her watching the five of them. After a couple of minutes of this, Posse patted Anna on the back and reached out to shake her hand, snapping his fingers against hers as their hands parted. He got back into the car, sitting down in his seat and closing the door. The driver turned the lights off as Anna stood on her tip-toes and leaned in to shake all of their hands; when she'd stepped back from the van, he turned on the engine and threw the car into reverse. In response, the girls and Phyllis leaned out the windows waving and yelling their goodbyes as they drove off.

Anna waved after them until they were out of sight then turned to House and Cuddy with a wide smile. 'What nice guys. It must have been great traveling with them!'

Once she turned, House and Cuddy looked at each other then Cuddy shrugged, rolling her eyes, before both followed Anna. She walked up the stairs and under the light. When they got up to her, Cuddy confirmed what she thought to be true: Anna was the woman in all of the screensaver pictures that Dr Agbo had. She was shorter than Cuddy and a bit on the heavier side -- since the photographs had been taken, her hair had bleached out a little and had gotten longer.

'How was the trip?' Anna asked, turning to them and looking them up and down. 'Besides dusty.'

'Eventful,' House said simply, and when Cuddy didn't provide an immediate addition to that word, Anna turned away from them and walked through the foyer.

She gestured to them. 'Come on, you can stay here tonight and I'll take you into Damongo tomorrow.'

'Is that where Dr Chase is?' asked Cuddy as she caught up to Anna.

'No, but it's where our house is,' she replied as she shut off the front lights.

For a long moment, House and Cuddy were afraid to move in the darkness, but then their eyes adjusted to the half-light created by the fire in the middle of the building. Having not seen it first in the daytime, Cuddy was confused by the layout, but once they stepped out far enough, she realised that what appeared to be a solid building from the road was in fact a huge square of porches looking down onto an open courtyard. In the very middle, a small Ghanaian woman in an old-fashioned nurse's uniform sat fanning at the fire which had a large pot suspended over it. It just happened that when Anna entered her sight, a small timer at her feet started beeping so she punched it with her toe, dropped the fan and stood, grabbing a set of tongs from a bucket of alcohol. She opened the top of the pot and began pulling out surgical instruments, syringes and needles, piling all of them into a clean, deep stainless steel tray.

'We're thinking about getting an autoclave,' Anna said, beginning to move from where the light switch was. 'But there's some question about whether or not it's worth it the way the power's been lately. Apparently the government thought it would be a good idea to sell our excess power to Togo.'

'_Our_ excess power?' asked House and they turned the first corner to walk down one of the sides of the square.

'I may not be a Ghanaian, but I live here and a lack of power has a profound effect on my work,' Anna replied, turning to smile at him.

House either didn't have a response, was being tactful or was too tired to formulate a response, so they just continued walking, the sound of metal on metal clanking and the clipping of dog toenails on concrete accompanying their steps. Shortly after their second right turn, Anna stopped and opened a door, turning on the light before letting them walk past her.

'This is the room for whoever is on duty at night,' Anna said as she stepped in and closed the door behind them and the dogs. 'We prefer that the dogs sleep inside, so if it's okay, they'll stay in here with you.'

House looked poised to respond negatively, but Cuddy managed to give him a dangerous look before he said anything.

'We've been good on water lately, so there should be enough water in the tank for you to both take showers,' Anna said, walking to them and taking their bags. 'There's no water heater, but you'll at least be able to get the dust off.'

Anna brought their bags over to a low dresser and set them down, looking at them critically.

'Didn't you bring anything else?'

'We were held by guards at a customs checkpoint about an hour from Kumasi and the tro-tro we were riding left without us but _with_ our luggage,' Cuddy said, looking down at the batik dress that Phyllis had picked up for her. 'The older woman with us today bought a set of backup clothes for us, but other than that, we don't have anything.'

'Well, there are toiletries in the bathroom and I'd be more than happy to lend you some pyjamas,' Anna said with a sort of naïve smile.

Something about the combination of Anna and the delightfully Western-style room from its normal bed to the small oriental rugs on each side of it made Cuddy feel very at ease. She walked over to the dresser and slipped her shoes.

'Where is Dr Chase?' asked House.

'Down in Mole,' Anna replied as she opened a drawer near Cuddy's feet and retrieved two towels, standing to hand them up to the taller woman. 'She's been gone for four days now, so she'll probably be back either tomorrow or the day after.'

House crossed his arms and leaned against the wall. 'Tell me about your education.'

'What does her curriculum vitae have to do with anything right now?' asked Cuddy as Anna began getting two shirts and a pair of pyjama pants from the higher drawers.

'It's all right, Dr Cuddy,' Anna said in an accommodating voice. 'I earned a BSN at Johns Hopkins and my MPH in both family-community health and global health at Harvard.'

'Impressive,' House replied, nodding his head. 'How did someone with your level of education make a stupid decision like coming to a place like this?'

Anna raised her eyebrows calmly. 'I think some things can wait until after you've both had a good night's sleep.' She focused back on Cuddy. 'Is there anything else I can get for you, Dr Cuddy?'

'No, you've already done enough,' Cuddy said gratefully, holding the towels to her chest.

'Well, if you need anything at all, I'll be sleeping in the office -- if you walk across the courtyard, it's the first door on the left near the entrance,' Anna said. 'And in the morning, sleep as long as you need. We tend to be pretty quiet around here, so there shouldn't be any noise waking you up.'

'Thank you, Anna.'

She nodded. 'I'll see you in the morning then, and thank you both for coming. It's still so surprising to see Dr House here!'

She let out a little happy puff of air then went to the door followed by Cuddy. Cuddy watched her walk to the nurse sitting in the courtyard and listened for a moment as they started up a quiet conversation in whatever language happened to be prominent in the area. When Anna started moving again, Cuddy closed the door and turned around to glare at House.

'_How did someone with your level of education make a stupid decision like coming to a place like this_?' Cuddy said in a harsh whisper. 'Way to start off on the right foot, Greg.'

'Hey, she appears to worship me already, so I figured I had some leeway with her.'

Cuddy rolled her eyes and then walked past him to the bathroom, setting their folded towels in the sink before peeking into the shower to see what toiletries were available. As she set up her cleansing area in a rather OCD way, House propped his cane against the wall then went to sit on the bed. As he pulled off his shoes and socks, one of the dogs nuzzled into his back as the other stared at him from the end of the bed. He looked up as Cuddy's dress flew out of the bathroom followed by her undergarments before the door was closed most of the way. When the rings of the shower curtain scattered across the metal pole, House followed her lead and took off his shirt and pants, throwing them at her clothes. The water came on and immediately Cuddy whimpered and began a steady chant of 'cold, cold,cold!'. Limping over to the door, he leaned against the frame.

'Anna seems nice,' House said then shrugged.

'Right,' Cuddy said in a shuddering voice. 'I'm sure she feels just the same about you.'

'Hurry up,' he replied.

'Why don't you just join me?' she said sarcastically, making a little scandalous noise as House's shadow came closer to the shower curtain. 'I was _kidding_!'

She turned the water off and reached blindly for her towel before House opened the door and grabbed one of the towels, shoving it into her hand. Behind the curtain, she wrapped up tightly before stepping out, brushing past him and walking back into the bedroom, pulling the door closed after her. The latch didn't catch, leaving the door to swing ajar as he stepped into the shower.

'If there's no water, I'm going to be forced to have my way with you as repayment,' House said at a socially unacceptable volume; Cuddy grimaced, hoping that Anna hadn't randomly decided to walk back and stand in front of the door at that moment in time.

After drying her hair off, Cuddy pulled on the t-shirt just in time to avoid standing stark naked in front of House which, by the dammit he muttered upon exiting, was contrary to his reason for taking an amazingly fast shower. She turned her back to him as she pulled on the pyjama pants Anna had given her then walked over and fell back into the bed. Taking that as some sort of cue, both of the dogs, who had been sniffing their clothes, jumped onto the bed. They were obviously used to one person sleeping with them, so when House finished changing into pyjamas, he had to shove the dogs over and down so that they were mostly on Cuddy. Once he was settled, the dogs seemed to consider their positions and decided it made more sense to sleep in the obviously rarely used dog bed by the dresser. House pulled the covers up and looked at the ceiling.

'Aren't you going to turn the lights off?'

'No, I have a theory,' House replied, then looked over at her. 'You know, this is our third night sharing the same bed and I've come to the determination that we're like a married couple: pre-bed fights and a huge lack of sex.'

Cuddy groaned. 'Grow up, House.'

He chuckled once then looked at the ceiling once more. A few moments later, the light flickered and the power turned off for the night.

'Theory proven,' he murmured. 'Goodnight, Cuddy.'

She turned and smiled into her pillow. 'Goodnight, House.'


	11. Chapter 10

When Cuddy woke up the next morning, she quickly realised that it was actually the afternoon. There was a certain amount of panic when she got up, scrambling rather ungracefully onto one of the oriental rugs on the floor, but she suddenly remembered last night's conversation with Anna and found herself rather relieved that the quiet woman kept her promise of leaving them alone to their own sleeping devices. She stood up straight and tipped her head forward, looking down at her borrowed pyjama top as she tied her hair back. After walking to the door as quietly as possible to avoid waking House, she opened it and looked outside to see that he was already in the courtyard. She peeked back and realised that what she believed was House in the half-light of the room was really the two dogs curled up partially under the sheets. She sighed.

'Come on, you two,' Cuddy said, and the dogs immediately perked up and jumped off of the bed, stretching theatrically before walking past her and into the courtyard.

As Cuddy closed the door to the room, Anna appeared from the room next to theirs, a clipboard held on her left forearm as she wrote notes with a slightly dour face. Seeing her in daylight was very different -- she looked exactly like the young woman in the pictures on Agbo's computer rather than a tired, older version. She pushed stray hair back from her face, and once she saw Cuddy in her peripheral vision, she closed the patient door quietly and looked up at Cuddy with a smile.

'Good afternoon, Dr Cuddy,' Anna said in a soothing tone. 'Did you sleep well?'

'Yes,' Cuddy replied. 'Thank you so much for letting us sleep in.'

'Dr House actually only slept until a little after sunrise,' Anna said, tapping her pen on the clipboard as she walked up to Cuddy. 'Is that odd? You look sort of confused.'

'What's he been doing?' Cuddy asked with a raised eyebrow as she walked to the stairs, setting her hand on the pillar on the left side.

'He asked for all of our patient records and has been reading the narratives,' Anna replied, holding the clipboard to her bottom lip. 'There's been a lot of laughing.'

'What's your charting style?'

'Exception.'

'Fabulous,' Cuddy groaned. 'So in other words, he's been able to read only the most horrendous things that have occurred here at the clinic.'

Anna furrowed her brow. 'I suppose you could put it that way.'

Cuddy watched House's back as he sat at the table with a foot-tall pile of folders on his right and a three-inch-tall one on his left. As he finished looking at the chart that was in front of him, he took it and placed it atop the larger pile before taking another chart. He flipped it open as a woman walked over to him and placed a steaming mug of coffee by the left chart pile.

'If you're interested, Grace is starting to make lunch for the patients,' Anna said as she began walking down the stairs. 'You could maybe see what Dr House is looking for.'

'You didn't ask him?'

'No, of course not,' Anna said audaciously as Cuddy followed her down the stairs and into the courtyard. 'He looks like he's in the zone. If he's finding out something to help Natalie, I don't want to disturb him.'

Cuddy nodded before walking past Anna, crossing the courtyard past a couple of rickety looking benches and the fire then reaching House's table. She walked around it and sat down on the far side.

'Anna says you appear to be in the zone.'

House didn't bother looking up at her. 'If we're talking about the Twilight Zone, then yes, I am.'

'Are you looking for anything in particular?'

He did a little snort laugh. 'No. This is a playground for people who hold doctorates in infectious disease. These are the kinds of cases that they told us to never expect to see because although they're insanely fun, they're nowhere near the first world.'

She pulled one of the files from the shorter stack and opened it, setting it down in front of her to read the first few pages. 'Ah, wonderful, myiasis.'

House stopped reading and looked across to her.

'And look, Polaroids,' she groaned, holding the photographs up like she was playing poker with them.

'Let me see!' House said in a theatrical, whiny tone.

When she handed them to him, he looked over them slowly, flipping from picture to picture and studying each with narrowed eyes. He kept murmuring under his breath, wagging his eyebrows each time he pulled one of the photographs closer to his eyes. Occasionally, he looked up at her expectantly as though he was going to say something about the photographs but then apparently decided whatever he was going to say was even tasteless for him, so he kept it to himself. Cuddy kept watching this pantomime until Anna and the cook came over, the cook holding two bowls that she set down after Anna cleared the files away from in front of House.

'Grace made you some red red,' Anna said as she made the files into a neater pile. 'It's a sort of black eyed pea stew with fried plantains. Very tasty.'

Anna looked at the open file that Cuddy had pushed to the side, pulling it toward her and holding out her right hand to House.

'Please, I need the pictures back, Dr House,' Anna said.

'If you let me see this patient,' he said, waiting for approval of this statement before relinquishing his Polaroid rights.

'I figure you'll want to meet every patient,' Anna replied pleasantly as House handed her the photographs. 'After all of the patients eat, we'll go work on her.'

'And when you mean work...?' House started, his hand now hovering over his spoon.

'I mean just what you're thinking,' replied Anna before closing the file. 'Let me make sure that our assistants are taking care of patient meals and I'll be right back.'

When she walked back over to Grace, House and Cuddy began eating. The food was amazingly palatable and it was for that reason that they remained silent for the two minutes that Anna was gone. Once she'd assured everything was running smoothly, she came over with her lunch and a plate of pineapple for them all, setting it down in the middle of the table before sitting next to Cuddy.

'In the name of the Father, the Son and the Holy Spirit, amen,' Anna said, crossing herself and folding her hands as House openly stared at her. 'Bless us, oh Lord, and these thy gifts which we are about to receive from thy bounty through Christ our Lord, amen.'

She crossed herself again then smiled at House before taking a bite of her red red. He looked back down at his food, stirring it.

'So,' she said, then tapped her spoon once on the side of the bowl as though the sound would diffuse the discomfort between her and House. 'Natalie called a few minutes ago to tell me she'd be back by tomorrow.'

'Good,' House replied. 'I can have fun with the myiasis girl, check out some awesome third world grossness and diagnose the HIV woman in less than five days.'

He reached out and took a piece of pineapple, taking a bite of it before speaking through half-chewed fruit.

'Life is good.'

'I didn't know she could call you,' Cuddy said.

Anna dug into her pocket and retrieved an ancient-looking Motorola that had 'GH ONEtouch' typed across the middle of its bright blue screen. Despite the feeling of being in the middle of absolute nowhere, the little satellite icon in the top left corner showed full service.

'A lot of people including Natalie use another carrier called MTN, but I don't get good international service with it,' Anna said, flipping around the phone to look at the screen. 'I like to be able to call my parents whenever I want to.'

Anna set the phone on the table.

'Natalie doesn't have anyone to call,' she continued before looking up at them. 'But yeah, she'll be here soon enough.'

'Does she know we're here?' asked Cuddy as she watched Anna put the phone back into her trouser pocket.

'No, and I don't plan on telling her,' Anna replied then laughed. 'If I did, she might not bother coming back!'

'We should try to diagnose her before she comes back,' House said between bites.

'I'd like to see that,' Anna said with a snort and House gave her a condemning look at her doubting flippancy; she backtracked. 'She doesn't keep medical records on herself for whatever reason.'

They continued eating, Anna looking up every now and then to watch her underlings bring partially-consumed meals on trays out of rooms and study them before writing down how much the patients had eaten. She would slow down as she watched them, taking a pinch of food and holding it at her lips until the assistant had walked away. Conversation completely dropped as they finished their meals, all eventually getting to the pineapple and some cold Milo that Grace brought to them. Anna was the last to finish, grabbing all of their plates and taking them over to Grace before washing her hands in a covered basin filled with rather clear water. Once she'd dried them off, she walked back over to House and Cuddy, taking the files into her arms and holding them to her chest.

'Shall we go to the office then?'

Without waiting for a response, she turned around and walked up the closest stairs and under the eaves. House and Cuddy both stood, following after her as she walked to the front entrance, turning left toward a door that neither of them had noticed the night before. Inside, Anna dropped the pile of files onto the desk and began slipping them one-by-one into alphabetised slots.

'This is our office,' Anna said as she put one of the files into a slot that was numbered rather than lettered. 'Please, sit.'

Both of them came in and sat, Cuddy looking around the room to take in the environment. The office was painted much like the hospital in Kumasi, the same warm tones that really didn't help with the perception of heat gracing each wall. The desk was massive but a rectangle rather than the L of Agbo's desk but the chairs were the same as his -- this kind of chair was obviously the highest class of Ghanaian chair available. To the left of the main bookcase was a door with a biohazard symbol on it.

'So like I said,' Anna began as she slipped the final chart onto the bookcase. 'Natalie doesn't keep a medical file here, but I'd be glad to answer questions. I bet I could answer them better than Kwame.'

'How long have you known her?' asked Cuddy.

'I've been in Ghana for nearly two years,' Anna replied, sitting down behind the desk and looking at them. 'I worked at KATH then came up here soon after Natalie got back from her long trip to Australia.'

'And when was that?'

'Um... hm. I guess about a year ago,' she said, leaning back in her chair looking pensive. 'Yeah, it was. I spent Independence Day down in Kumasi then came up here during the Commonwealth Games.'

She spoke confidently as though House and Cuddy should have known exactly when these things occurred. Neither of them asked for more details in an attempt to save face.

Cuddy remembered what Agbo had mentioned about Natalie's time in Ghana. 'Did you work at KATH at the same time as Dr Chase?'

'No,' Anna replied. 'She had already gone back to Australia by the time I got here. Here to Ghana, that is, not to Sumpini.'

'In my department, there's an Australian named Robert Chase,' House said, leaning forward to put his hands on the desk. 'Do you know if she's related to him?'

Anna considered this. 'No. All I know is that her parents died within a few months of each other about a year and a half ago. She's never mentioned any other family.'

'No siblings? Has she been married?' House pried.

'None that she's mentioned,' Anna repeated.

'What did her parents do for their livings?' Cuddy asked.

'Her mom was a doctor, but she hasn't mentioned much about her dad.'

'What is her hometown?'

'I just know she's from Australia.'

House and Cuddy looked at each other with exasperation before House continued.

'Do you know where she got her degree?'

'Ah, now that I do know,' Anna said delightedly. 'She has degrees in pharmacoepidemiology and communicable disease epidemiology from the University of Newcastle.'

'I mean... is there absolutely anything else you can tell us, medically or personally?' Cuddy asked.

'She had really bad epilepsy when she was a kid but it's pretty much been under control until a couple of weeks ago. When she was about five years old, she had a seizure that was bad enough that she fell down the stairs and cracked her skull, had to receive a lot of blood and spent a few months in the hospital,' Anna said. 'And after that HIV test came back positive, Natalie told me that that was when she received the tainted blood that led to her HIV positive status.'

There was the clicking of the dog nails and Baring came in, stopping by Cuddy for a head scratching before walking over and laying in a dog bed next to the bookcase.

'The dogs belonged to her father,' Anna offered. 'She brought them back with her from Australia and neither of them were happy about it at all.'

Baring moaned and sighed.

'I think they've done a good job of adjusting though, and they seem to have helped Natalie's coping with her parents' deaths.'

They fell into silence once more, a common occurrence in this odd, ambient soundless place.

'I want to see that patient,' House said, pointing to the one file that Anna had left out.

Anna nodded. 'Let's go see her then.'

All stood, Anna keeping the file with her despite the fact that House looked as though he physically ached for the touch of the file's manila skin on his own. They walked out, Anna nearly running into Martin as he made his way into the office to curl up with his sister. They made their way through the courtyard then took a sharp left and finally stopped at the room next to the one that Anna had left that morning after Cuddy woke up. Anna stood in front of the door and turned to them.

'Her name is Mercy Nsiah and she's ten years old. She came to the Damongo hospital three days ago because of intense pain in her nose and boils on her back, chest and shoulders,' Anna said in a hushed tone. 'The doctors at the hospital identified the boils as botfly larvae but after seeing up her nose, they sent her to us because she requires more specialised and extensive care. They've all seen the boils and do the extractions for that, but...'

Anna took a deep breath.

'There are maggots _everywhere_,' she continued. 'We've cleaned out the ones in her nose, but they managed to migrate before she got here. I've pulled them out of her ears, they've gathered in a hole in her palate, we're still trying to get those botflies out because not all of them had come to a head. Just try to be calm about it because she's very uncomfortable. Today we're trying a new technique that I read about in a Malaysian journal article about myiasis -- one of our assistants brought some turpentine from Damongo and we're going to use it to flush out the maggots.'

After nodding to herself, she opened the door and walked in, turning on the lights and immediately saying something including their names to the girl. She moaned in response and Anna gestured to them as she checked the girl's IV site and injected a bolus of what they assumed was some sort of analgesic into the port on the girl's hand. House stood at the door and allowed Cuddy past him before going in and closing the door quietly. Cuddy walked to the end of the bed and laid her hands on the footboard, looking up at the girl. House waited by the door and watched Anna gather the supplies. Once the metal plate was full of what she needed, she rolled it over to the bedside, the thing squealing horribly as the wheels jammed around in their covers.

'We've already tried saline for the oral and nasal myiasis,' Anna said as she lined up the supplies then said something to the girl which caused her to open her mouth. 'Come around on the other side and you can see what a miserable failure that attempt was.'

Cuddy stayed where she was but House walked over and stood on the other side of the bed, looking down into the girl's mouth where he could see grey squiggling things fighting in her palate. Many of her teeth were missing and the ones that remained were various shades of yellow and black.

'We're attempting to encourage oral hygiene in the family,' Anna said as she opened a bottle of turpentine -- the aroma washed over them like a thousand paint-killing olfactory memories. 'We'd like her younger siblings to avoid this problem.'

'Obviously,' House said.

'Can you put the head of the bed up?' Anna asked as she dropped a large cotton ball into an emesis basin of turpentine. 'If this works like they talked about it Malaysia, we're gonna want her up so she doesn't choke on the maggots.'

House looked at the side of the bed, suddenly unsure of the procedure around an insanely old-school bed.

'The foot of the bed,' Anna said, laughing at the mystified look on House's face. 'There's a crank. Can you get it, Dr Cuddy?'

'Of course,' Cuddy said, crouching down and cranking the handle -- it was incredibly noisy, but Anna and Mercy didn't seem at all phased by it.

'Now, if you'll come and sit next to Mercy on the bed,' Anna said, looking at Cuddy. 'Just sit near Dr House.'

Cuddy seemed unsure about this, but came around and sat down without protest, finally looking into Mercy's mouth as one of the maggots lost its grip and dropped onto her tongue. House and Cuddy both flinched as Mercy leaned forward and it fell onto the sheets.

Anna said something to Mercy in a slightly berating tone and she leaned back again as Anna reached out and handed another emesis basin of turpentine to Cuddy.

'Hold this right under her chin,' Anna said, then turned back and grabbed the cotton ball of turpentine in a pair of forceps. 'Would you like to do the honours, Dr House?'

He shrugged, trying his best to appear bored despite the fact that this was one of the most exciting and disgusting opportunities he'd had in awhile. 'Why not?'

She handed the forceps over Mercy and House took them, leaning down to put it in Mercy's mouth. As Anna gave Mercy instructions, House held the turpentine-impregnated cotton ball up near the area where the maggots were congregating. Almost immediately, they began rushing out of the area. Anna helped Mercy lean forward and dozens of writhing maggots spilled out of her mouth and into the emesis basin. After each splashed into the liquid, it was dead within seconds. Once the flow ebbed, House removed the cotton ball and Anna quickly leaned in to examine the area with her penlight. Pleased with the results, she took a syringe of normal saline and sprayed it into the area.

'Looks good,' Anna said, looking over at the emesis basin in Cuddy's hands; rather than taking it from her, she simply leaned over and picked up the maggot that fell from Mercy's mouth, rather unceremoniously dropping it into the basin with her bare hands. 'Next task then...'

Cuddy stood, looking down at the basin of dead maggots and walking slowly around the bed to set them on the instrument tray as Anna pulled back Mercy's covers and exposed the girl's chest.

'Wow,' House murmured and Cuddy was tempted to leave the room right then, but for some reason made the mistake of turning around to see what was worth wowing about.

Dotted all over the girl's chest were healing bright red spots, a few brownish yellow bumps and, the most horrifying of all, two places where grey-yellow larvae were sticking out a quarter-inch from her skin.

'Ooh, good, look at that,' Anna said as she looked between the larvae and House. 'Want to have another go?'

House held himself back from obvious schoolgirl bliss and handed the forceps over to Anna, receiving a pair of tweezers in response.

'Grab them right at the head,' she said, pointing at the end of one of the botfly larva with her pinky finger. 'Don't play around with it; when you grab it, pull it out and don't let it break.'

Without the slightest hesitation, House grabbed onto the one closest to him and yanked it out as Mercy moaned groggily; Cuddy found herself wondering exactly how much analgesic Anna had given the girl when they walked in. House held the larva aloft, looking at it carefully as it wiggled around on the end of the tweezers.

'Basin?'

Cuddy reached for the emesis basin again, stepping forward to hold it over the girl as House dropped the larva in to join its maggot brethren. The second extraction went just as quickly, House watching the larva that time as it writhed and died. With that sensation that follows a job well done, House stepped back and watched Anna examine the botflies that hadn't yet erupted.

'That's really the only interesting part,' Anna said from close to Mercy's chest, rubbing a gloved finger over one of the welts. 'If you two want to go do something else, feel free. I just need to bandage her and clean up in here, then I'll come and get the two of you to meet the other patients.'

She stood straight and looked at them.

'Go out into the courtyard and ask for Muwinyo. She's making a trip into town and will pick up clothes for you, but she needs to know your measurements,' Anna said as she took the emesis basin from Cuddy. 'If you don't mind, I'd rather you stay here at the clinic instead of me taking you into Damongo -- we got a few more patients this morning, so I don't think I can get away long enough to acclimate you to the town.'

'I don't think we have a problem with that,' Cuddy replied for both of them before looking down at the oozing wounds on Mercy's chest. 'You're sure you don't need anymore help?'

'Just lower the bed on your way out. I have this handled.'

'Do you get a lot of cases that are as bad as this?' House asked, slowly making his way toward the door.

'We get the worst of the worst,' Anna said in an unreadable tone. 'I've seen diseases here that I never thought I'd ever see, things that I'd heard about at Harvard but sort of assumed they were urban myths. Africa certainly isn't the real world, Dr House.'

Cuddy went to the foot of the bed and lowered it once more and as she did so, Mercy coughed and another maggot fell out. Anna laughed, grabbing it and dropping it into the basin, and Cuddy darkly looked over the footboard at her. They met eyes.

Frowning, Anna spoke. 'Dr Cuddy, when you've been here as long as I have, you have to laugh or you'll just cry all the time.'

---

A/N: First off, thank you for reading and reviewing! I adore getting story reviews in my eMail especially considering this time of year -- I just took my fundamentals of nursing final and Thursday is my pharmacology final, so having happy little breaks where I read wonderful reviews really makes my day. I love that all of you seem to really be enjoying Occlusion and the comments about my characterisation of House and Cuddy are definitely my favourites!! I really hope to finish writing this over the holidays and then attempt to do a weekly update to the end -- currently, I believe it will be about twenty to twenty-five chapters, but we'll see where that goes, heh.

For those who haven't been reading since the beginning, yes, I've been to Africa. I work at a school for mentally challenged students in Kledjo, Ghana, West Africa, which is outside of Hohoe in the Volta region. I spend at least a month there during the summer. Occlusion takes place in the region of West Gonja which is a sixteen-hour-long drive from Hohoe -- I know this because I had to make that drive last summer. All of the details in the ride from Kumasi to Sumpini are from my own experiences during that drive from hell including the horrible tour guide, Posse and the hitchhiker. ALL of those events occurred -- pushing the van, not being able to turn, the speedometer breaking, pieces falling off of the van, speeding through towns and of course that atrocious road from Fufuitso to Larabanga. I've heard it's worse coming from Tamale to Larabanga, but I highly doubt anything could be worse than the Kumasi-Larabanga route, ugh.

If you want to see pictures from Ghana, my Flickr is my homepage on my author profile. If you ever have any questions, please PM me and I'll be happy to answer when I get the chance.

So yes, thanks for reviewing and I hope I'll get this all finished very soon (with the possibility of a sequel, ha!). Enjoy watching House tonight -- I hear there's some Huddy, wahahahaha!!


	12. Chapter 11

According to Anna, Natalie Chase's homecoming was never a quiet event. No matter what time she showed up in her Defender One-Ten, middle of the day or dead of night, there was always a welcoming party. This return happened to fall in the latter, her rumbling all-terrain vehicle turning off of the dismal red dust road at two-thirty in the morning. Despite the fact that neither of them had ever seen anyone communicate on the phone with Natalie -- Anna had of course shown her mobile but they'd never seen it actually _call_ anyone -- the entire population of both the clinic and houses surrounding it were up and at 'em like they had a sixth Natalie sense. She was their celebrity.

The delightful intrathecal morphine long worn-off, House had woken up to his leg aching, so he was wide awake when murmurings of the language du jour began outside of their door. A new light besides the glow of citronella candles and fires pilled through the windows and there was suddenly a burst of excited movement and noise. There was the distinct sound of a massive engine amongst the voices for a few seconds followed by momentary silence before a door opened and welcomes began. More doors were opened and the sound of unpacking ensued. House sat up in the bed as the sounds came closer and non-vehicle doors started opening. Amongst it all, he finally heard a thick Australian accent answering a question posed by Anna's firmly New Hampshire voice.

Across the way, someone dropped something large and the sound was enough to jar Cuddy awake.

She jumped before slurring lazily. 'What's going on?'

'I think Dr Chase is back,' House replied quietly as it grew quiet outside -- a closing door gave him the hint that Natalie was doing rounds. 'She had a massive welcoming committee.'

A beep, and Cuddy's face appeared in the soft glow of his iPod screen. 'Jesus, it's almost three in the morning.'

He listened to make sure no one was coming, then turned to Cuddy. 'Go back to sleep. We'll meet her in the morning.'

He was about to lay down when there was the sound of careful steps in front of their room. House tensed up as the door clicked.

'Baring, Martin,' murmured Anna, whistling lightly, but to no avail. The dogs didn't respond to her call, Martin going so far as to moan and roll onto his back.

'Anna?' Cuddy asked from her pillow before sitting up. 'Why are you--'

'Why are the dogs in there instead of out here with me?' Natalie asked in a jocular tone, walking right up to Anna -- House could see her hand as she reached up to grab a chunk of Anna's hair and scan the edge for split ends. 'I'm sure they've stayed as lazy as always.'

Anna didn't move, and this was something that obviously made Natalie uncomfortable. She dropped her hand to Anna's, slowly pushing the door open and shining in the torch she happened to have in her hand.

'Has little sister found a boy? Is it perhaps a Dr Kwame Agbo?' she laughed, but the smile absolutely dropped from her face as she looked from Anna to the two in the bed.

There was an immediate silence during which Cuddy, still mostly asleep, seemed poised to make a run for it. Light flashed in House's eyes and he squeezed them shut, holding his hands in front of his face. There was a mutual sense of displeasure as they remembered telling Anna that no, they didn't want to go into Damongo, they wanted to stay in Sumpini, and...

'Now what the fuck is this?' Natalie said in a tone somewhere between surprise and utter anger.

Once the beam of light had been diverted from his face, House opened his eyes and looked at the outline of the woman standing at the door. A group, obviously concerned by her outburst, had gathered behind her with their citronella pots, the glowing giving a spooky cast to the entire room. Slowly, as though concerned that she would use that huge rifle he saw hanging from her shoulder, he reached over and turned on the lamp next to the bed so he could see the illusive Natalie Chase. He'd somehow managed to convince himself that the woman would look like a female carbon of Robert Chase, so he was a bit taken aback when he saw a tall, dark-haired woman with relatively strong Indian features. Her skin was very tan and obviously as dirty as the stereotypical safari garb she wore. As she stepped farther into the room, the air was tinged with a trace of the wild mint that Anna had mentioned grew throughout the highlands around Mole National Park.

'Why did you come here?' Natalie asked in a fairly normal voice -- assured that their fearless leader wasn't in grave danger, the crowd almost immediately began to disperse. 'I had a seizure, I hit my head, I was unconscious for awhile, but now I'm fine. You have no business being here.'

The dogs, obviously worried by the tension in their lady's voice, slinked off of the bed and walked over to her, both sitting down and looking up at Natalie. She didn't pay them any mind, ignoring them in favour of glaring at House and Cuddy. Baring whimpered quietly for a moment but then fell silent when Anna crouched down and pet her head.

'I didn't think they'd come,' Anna said meekly. 'I just had Kwame call Princeton-Plainsboro for a second opinion.'

'No, you had him call Gregory House for a second opinion,' Natalie said, switching the torch off with a snap. 'You know, he's not the be-all, end-all of the diagnostics world as much as you _and _he believe he is.'

'I'm pretty damn good,' he finally hazarded, raising his eyebrows with a certain level of snark.

Although she was thinking it, Cuddy didn't bother giving House a dry, sarcastic look at his comment as she was still half convinced that Natalie was going to kill him or perhaps both of them. Natalie's hand came to rest on the strap of the gun over her shoulder and even House flinched as she slipped it off and the butt clattered on the floor. More silence stagnated over the group before Natalie took a few more steps toward them then jutted her thumb toward the door.

'Both of you, out of my bed,' she said, sounding amazingly defeated. 'Anna will take you to Damongo for tonight and I'll be by before noon to drive you to Tamale where you can get a flight to Accra.'

House and Cuddy both got out of bed without complaint, Cuddy making a beeline over to the dresser to begin gathering their new clothing into a burlap Melcom sack that Anna had provided, but Natalie took a couple of steps toward her and grabbed her wrist, pressing it against Cuddy's chest to push her into a standing position again. As she looked into Cuddy's eyes, her gaze was utterly cold.

'Anna will pack for you as soon as she gets back from Damongo tonight,' she said with a little smile then turned around to look at Anna, who rubbed Baring's head one last time then stood.

'Come on, doctors,' Anna said with resignation. 'It's not that far of a drive.'

Cuddy walked around Natalie and joined Anna as Natalie began to remove her outer shell of safari gear and untie her hair -- it was rather long and had a slight wave to it, or at least it seemed it would be that way if the layers of grease and grim were washed off. As House joined them, Natalie grabbed a towel from the top of the dresser and turned, looking Anna up and down before saying something to her in what appeared to be Twi. As she spoke, Anna nodded over and over again, looking down at the ground then answering as soon as Natalie delivered what seemed like a heartfelt, pissy rant. Natalie rolled her eyes then walked past the group and Anna turned and left the room. House and Cuddy followed, closing the door behind them and both wondering what hatred was exchanged but prudent enough to realise it was best to leave such questions unasked.

They walked through the courtyard then up and down the stairs to a mud encrusted Defender One-Ten. A few people were still hanging around it, all sitting on large boxes that had been unloaded. Anna said something to them and they all stood, moving the boxes to the bottom of the stairs before sitting down again and watching the three of them get into the massive vehicle. Anna got into the driver's side -- on the right, the opposite of other Ghanaian vehicles -- and Cuddy sat next to her as House sat on the long bench behind them, his legs thrown along the length. The Land Rover roared to life and Anna sent it into reverse, rolling onto the bumpy road then driving the direction that the trotro with the Hohoe volunteers had headed. They were passed by no one.

None of them said a single word during the entire drive -- though, to be fair, House kept drifting off to sleep, Anna was too busy attempting to avoid the largest potholes and Cuddy was too on edge trying to prepare for any pothole she accidentally hit. It was a long drive, Anna murmuring something about around thirty miles, so it was over a half hour until they got there. As they got closer to the city, yellowish streetlights began dotting the sides of the road and solidly built concrete buildings sat almost imposingly as far as they could see. They turned down a rather dusty road and Anna paused for a group of three goats to pass them before pressing on. About five more minutes of driving and they stopped in front of a set of short steps leading up to a gate. Anna turned the Defender off and slipped out of the vehicle, opening House's door and watching as Cuddy slipped across the seat to come out the driver's side door.

'Welcome to our home,' she said quietly, turning around and walking to the gate, unlocking it and letting the heavy door creak open.

As they stepped in, Anna threw a switch and a loud light overhead began buzzing. Almost immediately, a few stray flying termites appeared and House inwardly flinched at the memory of the girls discussing the eating of oh-so-yummy termite crisps. Behind them, the gate slammed shut and they walked into a central courtyard surrounded by three houses. In one of the houses, a person coughed. Anna walked between two of the houses and stepped up onto the step of the house directly in front of them.

'No one's been here for about a week,' Anna said as she went to a door and turned an ancient-looking lock. 'It might be a little dusty, but if you're just here for the night...'

The lock clicked and the door fell ajar. Anna pushed it open and slipped the key ring into the pocket of the apron she was wearing as House and Cuddy walked into the house. They stood in the darkness for a moment before Anna wove her arm around and switched on the light. The main room where they walked in was very small -- there was a velveteen-covered couch on the left, a curtain-covered recessed kitchen on the right and a bead curtained doorway in front of them. Anna strode forward, walking toward the doorway and not bothering to look back and check that they were following. As she crossed into the next part of the house, she turned the lights on, pausing to decide which of the two rooms in front of her that she would take them to -- the door to the immediate right was already open and the tile floor promised a bathroom. A moment passed and she continued directly forward, creaking open the door to a bedroom. She stood in the threshold with her hand on the handle, blocking them from entering.

'That's the bathroom if you need it,' she said, pointing to Cuddy's right before throwing a thumb to the other door. 'That's the other bedroom, but it's Natalie's personal bedroom, so...'

The rest was easily left unsaid.

'Well,' Anna said, flipping the switch to the bedroom. 'Here it is, and I guess I'll be back in a few hours to take you to Kumasi.'

'Tamale,' House replied.

'Wherever,' Anna groaned.

Cuddy noticed the slightly more peeved look that House had in response to Anna's resignation. Before he was able to do anything about it, Anna had walked around them and was already to the door, flipping off the light in the room where they were standing, leaving them in the dark to listen to the strings of beads in the doorway tap against one another. A few more seconds passed and Anna was gone, all lights off including outside, and soon after, they heard the Defender's engine rev up and the cracking of the tyres as she drove off. They stood there soundlessly for about half a minute, looking at each other with unreadable expressions before House wandered into the bedroom and fell into the bed with a grunt.


	13. Chapter 12

Cuddy didn't sleep. She wasn't sure if it was because she was constantly expecting Natalie Chase to come barging through the door to kill them or if it was... yeah, no, it was expecting Natalie Chase to come barging through the door to kill them. Even House was sleeping fitfully until the first light of dawn began creeping though the batik curtains lying listlessly atop slatted glass windows. The early humidity promised an almost unbearable day, a fact which was not lost on House when he got out of bed grumbling something about how he didn't actually need running water to take a shower. Despite this, he commandeered the shower first as Cuddy dug up a few sachets of Abba water and a half package of McVitie's Digestives in the kitchen. The digestive biscuits were moderately stale but she crunched away at one between sucks on the corner of the plastic baggie of chlorinated water.

The shower had just turned off when Cuddy became aware of the sound of an approaching vehicle -- it appeared to be one of the myriad red and orange taxis she'd seen both in areas south and passing the clinic. She drank the last bit of the water then flattened out the bag on the tabletop as House stepped out of the bathroom, his dirty pyjamas pulled on over his clean body. He'd made it to the table and grabbed a biscuit before the grumbling engine noise vanished and the gate to the compound opened. There was the sound of two people walking through the courtyard followed by the clicking of a key sliding into the door cylinder before the door opened and Anna walked in with Grace, who was holding a towel-covered metal bowl.

'Oh, you're awake,' Anna said sotto voce. 'I thought you might want some breakfast, so I brought Grace here to make you something before the two of us head back to the clinic.'

'Wait,' Cuddy said as she folded up the plastic bag. 'So we're not...?'

'I'm not taking you to Tamale,' Anna said with finality as Grace turned on the hob. 'Natalie was called to go into Burkino Faso with MSF, so she'll be gone for at least five or six days.'

'Fortuitous,' House said dryly as he sucked on the edge of a biscuit.

'I'll need a favour though,' Anna said as she sat down on the arm of the couch where both were sitting. 'Dr Chase was gone for a very long time and during that time, I neglected some needed house calls. I'd like one clinician to stay at the clinic and the other to come with me for those calls.'

'I don't...' Cuddy started, fading out as she looked over at House.

'For these cases, I'd prefer Dr House if that's alright.'

'What kind of cases are we talking about here?' House asked, not bothering to look at Anna.

'They're just people who can't leave their houses anymore. They have special needs and we cater to them.'

'Catering doesn't appeal to me,' House replied quickly. 'You'll have to come up with something better than that.'

'The ones who stay at home are the hospice patients. They have the worst diseases and the highest morbidity. Going on house calls around here, you see things that you'd never see in school, in the Western world and rarely in literature. I think you'd be able to find at least two or three interesting things,' Anna said relatively quickly. 'And you'd be able to get away from the clinic and Damongo.'

House considered this for a long moment as Grace poured whisked eggs into a hot pan. 'Fine.'

'Wonderful,' Anna said with cautious optimism, appearing almost afraid that he'd take it back if she seemed too happy. 'When you've finished with breakfast, the four of us will head back to the clinic then you and I will get on the motorcycle and go out for rounds.'

---

It was nearly eleven when Anna finished her late morning patient assessments and paperwork. Cuddy, being a consummate professional, made a point of going around with Anna and participating in the assessments of patients that she'd certainly met over the last couple of days but didn't know enough about them to be their primary caregiver for the day -- if people were unable to speak English at Princeton-Plainsboro, she simply called an interpreter or depended heavily on the monitors to let her know anything important. With her interpreter gone and the closest thing to a monitor being some combination of a stethoscope, BP cuff and a screaming patient, she was admittedly rather concerned, but Anna comforted her by mentioning in passing that the Ghanaian nurses employed by Natalie did a lot of the day-to-day care and that one in particular was completely fluent in English having earned her nursing degree in London.

'We shouldn't be gone for more than five or six hours,' Anna said to Cuddy as she strapped a couple of bags to the back of the motorbike they were using for rounds. 'If there are any emergencies, Grace has my mobile number.'

She tightened the strap on the last bag and turned to look at House.

'Are you ready to go, Dr House?'

Without a verbal reply, House walked over and handed Anna his cane then mounted the bike. Anna slipped on behind him, both hands on the cane as she set it between them. After a moment, she cautiously put one hand at his waist, watching Cuddy as she did so, keeping the other firmly grasping the cane. As House started the motor, Anna held her knees closer to the bike and watched back at Cuddy as they moved toward the road.

'Take a left,' Anna said near his ear. 'We'll go to Busunu then branch off from there.'

House nodded then sped off, a large puff of dust in his wake. Cuddy laughed a little as Anna's trepidation melted away and she put both arms around him, her face pressed against his back as he went all Jack Bauer on the hated red dirt road. Her eyes followed them until they disappeared over a small rise, and once the dust clouds had faded, she turned and walked back into the clinic, wandering over to the office to work on administration.


	14. Chapter 13

There was palpable silence between Sumpini and the closest large town, Busunu, but somehow it managed to avoid being awkward. At Busunu, House stopped for a moment to allow a group of goats to cross the road and Anna took that opportunity to begin giving directions -- it was a right up ahead and from that point, she'd pull at his shirt to guide him rather than yelling over the rather loud motor. They powered through the dirt, driving past small thatch encampments surrounded by millet fields and cacao orchards. About forty minutes after they'd left the clinic, they finally arrived at a completely unmarked village. Anna tugged at the left of his shirt and he turned, stopping the motorcycle in front of a circle of five houses. Once he kicked the stand down, Anna slipped off of the back, handing him his cane before stretching. He took the cane and stood, staring at the mud-and-thatch houses in front of him as Anna unloaded their supplies. Once she gathered everything, she stood beside him and looked up.

'We have just one patient in this village,' Anna said, holding up a file and letting the biggest bag fall into the crook of her arm as she handed it to him. 'Yaa Addo.'

He took the file but did not open it. 'We drove almost an hour to visit one patient?'

Anna gave him a dark look before brushing past him to run to the middle of the circle of houses -- a woman had walked out and yelled Anna's name. As she reached the woman, the woman threw her arms around Anna as they both began to chatter at the same time. House watched from the outskirts for a moment before Anna began looking at him almost imploringly. He had almost made it to her when a small face peeked around the doorway of the hut from which the woman had appeared. Anna took one step toward him and took his arm.

'That's Esi. She speaks fluent English. She'll take you to Yaa and knows everything that needs to be done,' she said simply before passing off the largest bag, which was embroidered with 'Cader' in frilly letters.

Once she'd returned to conversation, House listened for a few moments before walking past them with the bag thrown over his shoulder. As he came closer, the child disappeared from the door and one by one the dirty cloths covering the window holes in the mud walls of the house slid open. He had only a moment to glance at the chart before the girl, clad in a faded brown and orange school uniform, reappeared at the door and held out her hand professionally.

'Mma aha.'

House considered this seemingly unfamiliar string of letters before something clicked. 'Yemu.'

'I am named Esi. We have not met, sir,' she said in relatively stilted speech. 'How are you faring in Ghana, sir?'

'Fine,' he said a bit shortly. 'Nurse Cader said that you'd take me to Yaa.'

The girl gave a half smile then stepped aside, casting her open hand at the area behind her. 'I welcome you to our home.'

He began walking past her and she immediately took the bag from his shoulder, awkwardly pulling it over the chart before turning to walk to one side of the room where she set the bag down and looked back to wave him over. As he walked toward her, she slipped back a sheet that was hanging from the ceiling to reveal a small woman curled up on a reed mat. Esi smiled at him once again before crouching down and shaking the woman's shoulder.

'Mama,' she said softly. 'Mama, wake up. The doctor is here.'

House once again opened the charting, aiming to do more than look at the patient's name this time around. He glanced over the cover sheet that carried the woman's history and diagnosis including a relatively recent CD4 count and viral load test, both presenting abysmal numbers. He flipped to the next page, stopping to look at a Post-It note with a single word on it: 'palliative'. It wasn't Cader's flowing writing that he'd seen written on the charts he'd read at the clinic, but rather a strict print that just screamed Natalie Chase. He brushed his finger slowly around the worn edges of the note before looking at the long list of ailments that the woman had endured from oral thrush to diarrhoea. She began to cough with the effort of failing to sit up, and without even looking at her, House spoke.

'Tuberculosis,' he said succinctly as he heard Anna walk through the door; her footsteps came closer and she knelt down beside him to pull something out of the bag. 'I don't know which antibiotics you brought with you, but we'll need--'

Esi interrupted him. 'We know about the tuberculosis, sir, we--'

Anna, in turn, interrupted her, sounding a bit flustered as she did so. 'Esi, your grandmother wants you outside. We'll take care of everything.'

Esi looked down, gnawing at her lip a big before leaning down to take her mother in her arms and kiss her forehead. Her mother reached up as much as she could to rub her daughter's shaved head before Esi got up, her wrist held under her nose as she sniffled, tears gracing the rims of her eyes. When she'd left the one-room hut, House looked sideways at Anna as she finally found what she was looking for in the bag and began pulling supplies out: a tourniquet, two pairs of rubber gloves, a disposable needle, gauze, a freezer bag and a catheter. She took the chart from him and put it in the bag before pulling out a glass vial; she collected everything in her hands then walked over to Yaa, dropping to her knees and spilling the supplies onto the edge of the mat, flipping off the plastic cap of the vial before beginning to speak in low tones as she snapped one of the pairs of gloves on. As she began prepping for the IV, she asked Yaa a question and the woman said a few things then she and Anna began to recite something.

House suddenly became very aware of what was happening. He walked to them, leaving his cane leaning on the wall beside the bag.

'No tubing, no IV fluids?' he asked as he looked down at the tiny ring of aluminium covering the neck of the vial she'd set in the dust.

Anna stopped her recitation, hesitating for a moment with her hand paused over the woman's skin before she started palpating for a patent vein again. 'Nope.'

He watched as she punctured the vein -- blood flashed into the catheter hub and she made quick work of advancing the plastic catheter and removing the stylet. She snapped off the tourniquet and looked down at the hub then capped the used stylet with a scoop before reaching behind her and grabbing the needle and vial, handing them up to House.

'It's your job to prep the needle and inject her.'

'Like hell it is,' he muttered, staring at her hand and the vial before reaching out and grabbing the vial only, scanning the label and raising his eyebrows. 'Secobarbital?'

'Please,' she said, pressing the needle toward him between her index and third fingers. 'I start the IV, but that's all I ever do.'

'You're a nurse. You administer the medications as ordered by me,' he said forcefully.

'Not this medication,' she murmured and looked at him for a long moment before he took the needle from her and uncapped it, flicking the cap down toward her before jabbing the needle through the metal film and flipping over the vial.

'How much?'

'Ten,' she said simply, turning back to Yaa and holding her hand.

House pulled back the plunger of the syringe, not bothering to be incredibly succinct in his measurement. Regardless, he looked at the syringe before blindly reaching down to Anna and tapping her shoulder with the hand containing the vial. 'Cap this.'

She took it from him and grabbed the purple cap by her knees, tapping the cap to the neck then holding it firmly in her hand as she looked up at him. 'You need to be where I am.'

'No, I don't,' he said, making the move to hand the needle to her. 'You need to learn how to do your job, nurse.'

She gave him a stern look. 'I'm advanced practise, so don't treat me like some throwaway, useless fresh grad. We're all health professionals from the NA to the double board certified doctor, Dr House. _This_ application isn't my job. Get down here and do it yourself.'

With that, she moved aside and stood, turning sharply away from him to go back to her bag and drop the vial in before grabbing out another freezer bag. She walked around him and settled herself at Yaa's head, taking her head into her lap and watching House as he looked blankly at her. He waited, considering whether he was going to let this injustice stand or simply do it himself. Anna's look remained stern, but tears were gathering at the rims of her eyes, so he decided that it was much easier to just do it instead of risking the creation of an upset woman who could just leave him in this horrid non-fluency-in-English place. Slowly, he sat down and set the uncapped needle on the reed mat before snapping on the other pair of gloves.

'Wait just a minute,' Anna said after a relaxed sigh, and House looked over as she crossed herself. 'In the name of the Father, the Son and the Holy Spirit, amen.'

House quickly looked away, barely containing a groan as Anna began her recitation.

'Enti mommɔ mpae sɛ: Yɛn Agya a wowɔ soro, wo din ho ntew, w'ahenni mmra, nea wopɛ nyɛ asase so, sɛnea ɛyɛ ɔsoro,' she said, pausing for a moment during which House looked over, focusing on her mouth as she continued in one of the most soothing tones he'd heard in his lifetime. 'Ma yɛn yɛn daa aduan nnɛ, na fa yɛn aka firi yɛn, sɛnea yɛde firi wɔn a wɔde yɛn aka. Na mfa yɛn nkɔ sɔhwɛ mu, na yi yɛn fi bɔne mu.'

Yaa closed her eyes. 'Amen.'

Anna grabbed the bag next to her and pinched off a piece of bread. 'This is the Lamb of God who takes away the sins of the world. Happy are those who are called to his supper.'

Yaa cleared her throat then spoke in heavily accented and well-rehearsed English. 'Lord, I am not worthy to receive you, but only say the word and I shall be healed.'

Yaa kept her mouth open and Anna dropped in the piece of bread. 'The Body of Christ.'

After she swallowed, Yaa closed her eyes and took a deep breath. 'Amen.'

'May the Lord Jesus protect you and lead you to eternal life,' Anna finished then placed both hands on the sides of Yaa's sunken face. 'She's ready now, Dr House.'

She never looked up at him, so after a moment, he looked down at the port and took it in his left hand, balancing it on his ring finger as he lifted the syringe and pierced the needle into the hub. He injected the entire bolus without any consideration of application time then quickly pulled out the entire IV contraption instead of just removing the syringe from the port. Yaa started bleeding from the IV site so he grabbed a piece of gauze from the mat and pressed it to her skin as she began to convulse. Anna simply held her head as well as she could, looking down with complete calmness and a comforting smile.

It seemed like only an instant later that she laid completely still, and Anna held her for another minute before slipping her head down onto the mat, crossing herself once more before standing. She looked moderately numb as she stepped to House, gathering the spent supplies with her still gloved hands -- she pulled off her gloves around the catheter and dropped all of it into the freezer bag. House picked up the cap he'd flicked at her and dropped it into the bag after her gloves. She sealed the baggie and walked over to drop it into the larger bag by the wall. She picked it up along with his cane and walked back to him.

'Do you need help getting up?' she asked a bit nonchalantly before extending a hand to him.

He took her hand and stood, looking down into her eyes once he was up and steady. She looked away after a moment.

'Here's your cane,' she muttered, pressing it into his hand.

She shifted the bag onto her shoulder before pulling the curtains around the place where the body laid. She went before House, stepping through the door slowly and taking the extended hand of Esi before saying something to her in low tones. The girl started sobbing as she clung to Anna, setting off a growing cacophony within the housing complex. By the time House and Anna were able to break away from the group and make it to the motorcycle, all of the people in the small village had gathered in front of the House, all theatrically wailing for the lost Yaa. House watched as Anna strapped her bag to the motorcycle, noting the lack of the other bag that she'd brought.

'Your smaller bag is missing,' he said over the wails.

Anna turned to look at him, wiping at tears that were sliding silently down her face. 'Esi's antiretrovirals.'

His lips parted slightly, but he did not speak. Anna nodded a bit then turned back to the motorcycle, tightening the strap around her bag. When she stood straight again, he walked past her and got onto the motorcycle, handing his cane to Anna before she got on behind him. He balanced the motorcycle before turning it on -- Anna made a move to grab the back of the bike, but House reached back and took both of her hands in his, pulling them to his waist. At first, she seemed even more unsure than she had back at the clinic, but as soon as they began moving, she leaned into him and grabbed tightly. He couldn't hear her, but a minute later, he knew that the wetness of his t-shirt was not caused by sweat alone.


	15. Chapter 14

The following hours were mostly silence, but each thought it was the other giving the silent treatment. The only original conversation took place in various unintelligible African languages between Anna and the villagers they visited -- she was very talkative with them, in fact, and for whatever reason, the typically unsocial House felt some vague gnawing of jealousy at her ability to both chat with and berate the ones around her. When he worked with patients, she interpreted fluidly but like a professional kept all of her attention on the villagers rather than looking between each speaking party during examinations. House actually began looking forward to any sort of vague conversation whether it be drivel or erudition.

They visited two other villages over the course of the afternoon, House carefully writing down the conditions he saw in both their patients and the people around them in an attempt to complete some ghetto version of an epidemiological report. Much to his displeasure, there was nothing that stood out as unusual amongst the denizens of the area -- most of the maladies seemed tied to poor health habits, though in a random aside at one point, Anna made a comment about how much habits had improved since they started their work in Sumpini. House cringed inwardly.

At the end of the day, House figured he could say that this was like a dirtier, hotter version of the Princeton-Plainsboro clinic after some catastrophe in which eighty per cent of their supplies had been decimated. As the shadows around them became longer and the world started to have a redder tinge to it, he became more and more eager to get back to the clinic where he could stretch out his legs in a horizontal fashion. They stopped at the fourth village of the day and visited one patient before Anna mentioned a return to home base and left the housing circle with House close behind. As she started packing the bike, he popped a Vicodin and for whatever reason decided to break radio silence with the New Hampshire-born nurse.

He considered a myriad conversation points before selecting one at random. 'You've spoken a different language at each village.'

Anna nodded. 'You're very perceptive.'

'Just well-travelled,' he replied. 'How many languages do you have to speak in order to function here?'

Anna looked over at him as though she expected him to make some sarcastic joke, but because he was moderately interested, he of course _appeared_ moderately interested. 'I speak five of the major tribal languages: Twi, Brong, Nzema, Dagaare and Gonja. Natalie speaks more, and more importantly, she speaks Hausa.'

'The lingua franca,' House managed to dig from his copious store of cerebral minutia.

'Yep,' Anna replied simply as she finished tightening the straps and started getting onto the bike.

House was handing his cane to her when a woman started yelling behind them. House made an attempt to ignore her, but Anna had already begun getting off of the bike to meet the woman coming toward them. She wiped her hands on her dress and placed them on her hips before beginning to chat with the woman. There was concern on her face at first, but it melted away as she started following the woman back into the housing circle. About midway there, she stopped abruptly and turned back to House, who had aborted his attempt to get on the bike and was instead staring at her wordlessly.

'We've been invited to have dinner before we go,' she said, gesturing for him to follow.

'It's already getting dark,' he replied quite matter-of-factly as he stood his ground. 'We need to get back.'

Anna smiled and whispered through clenched teeth as she walked toward him. 'In Ghana, you don't turn down an invitation to dinner.'

'I do,' House said with a little jerk of his head.

'It's at least a half hour drive back,' Anna replied. 'I know you're hungry; your stomach's been growling nonstop.'

'Cader,' he said as he looked down at her. 'I'm not eating anywhere but back at the clinic.'

'The cooking here's just as good,' Anna said, reaching out and taking his hand lightly.

He looked down at her hand with a raised eyebrow -- this was the first time she'd willingly touched him.

'It won't kill you,' she said, pulling at him as she made a move toward the housing circle. 'Not quickly at least.'

He continued to hold his ground with her pulling at him until his stomach started growling at which point he gave in and allowed her to guide him back to the housing circle and into one of the houses they had not entered during their examinations. They went directly to the back of the house where Anna chatted with the women who were cooking. He stood leaning against one of the walls as he watched the women pounding the cassava for fufu -- he hadn't had the pleasure of eating that particular root vegetable, but considering the look on Cuddy's face when she had a bite of Anna's fufu the night before, he figured eating it was going to be an endurance trial. After a few what he considered close calls with the mortar and pestle being used for the fufu pounding, he looked away and quickly had his attention drawn to a bag of grey that a woman was carrying toward the food. As she dumped it out, he saw dried, coiled-up full tilapia and a puff of scales. After one woman ladled stew into a bowl, the other woman dropped one of the fish into it -- he nearly recoiled in horror when he saw her turn to him and begin walking toward him with it. Wordlessly, the woman guided him to a table then set the bowl in front of him. When he looked down at the food, some of the scales wandered greasily from the fish. The eye looking at him was a very nice touch.

'It's not as bad as it looks,' Anna said in an undertone as she walked up behind him with a bowl of fufu in one hand and her own bowl in the other. 'And considering how far we are from Lake Volta, you should be very honoured that they've procured fish from there for us.'

She came around and sat across from him as a woman brought over a baggie of Abba water set in a bowl. Anna opened it and poured it into the container, washing her fingers in the bowl before grabbing a little pinch of the fufu with her index and third fingers then pressing her thumb into the dough -- her lack of dinnertime prayer disturbed House. She dragged the ball through her bowl of soup then put it into her mouth and immediately swallowed. As she peeled some of the fish off, she looked quickly between him and the women across the room who were almost staring at them.

'Eat.'

She put the hunk of fish in her mouth and sloshed it around before spitting the bones into her hand. Throwing caution into the wind, House mimicked all of her motions up to right after he put the ball of dough in his mouth. Chewing it, he screwed up his face and let his mouth drop open a bit before continuing to chew and then swallow it. The women across the room muffled their laughs.

'Oh my God,' he muttered. 'That is absolutely awful.'

'Bitter?' she asked, then laughed, saying something to the women then continuing. 'You're not supposed to chew it -- you just swallow the ball whole.'

'And choke?'

'You get used to it.'

'Hopefully we won't be here long enough for me to grow accustomed to the intricacies of Ghanaian eating.'

They both fell silent, House immediately forgoing the fufu and instead picking up his bowl and drinking the soup, doing his best to avoid the fish and scales. He was actually pleased by the taste of the peanut-buttery soup and even more pleased when Anna said something and a few minutes later, some boiled plantain appeared on the table. He picked up the pieces, dragging them through the remainder of the soup and eating quietly.

'So the term palliative,' he said as he stared at a piece of plantain.

Anna stopped with her fingers in her mouth, considering what he said for a long moment then swishing her fingers in the water. 'Euphemism.'

'Obviously,' he said with some slight exasperation -- was she going to be as closed about this topic as she was about all things Natalie Chase? 'Is this going to be a common event?'

'Fortunately it only occurs once a month, if that,' Anna said, looking harried for some reason. 'We only... palliate when we've exhausted all other options.'

'When people are beginning to burden their families.'

Anna gave him a sharp look. 'They don't consider the sick burdens here.'

'They don't actively call the sick "burdens". That doesn't mean they aren't,' he said, raising his eyebrows. There was a long pause. 'Does that even jive with their belief system here?'

'No,' Anna said quite simply before continuing in a much lower voice. 'Natalie has the charisma and power to convince people that anything is part of their belief system.'

'Is that what she did to you?'

The look Anna gave him could kill a person and it was enough that he was slightly taken aback. 'I don't condone what Natalie does.'

'You start the IV,' he replied. 'That's about how far physician-assisted suicide goes, and last I checked, the Cath--'

'I start the IV only because Natalie is so bad at them,' she interrupted, her eyes cutting over to make sure the women in the house were engaged in their tasks and not listening to them. 'She was making the patients go through agony before killing them. They need to be at peace.'

'How compassionate.'

'And I have a feeling that she kills more people than I'm aware of,' Anna continued in an almost paranoid tone, her eyes wide. 'She takes me to the Catholics, but I know that it's not only Catholics dying around here.'

House furrowed his brow and was about to ask her about the possibility of excommunication, but she didn't give him a chance, instead moving onto a completely different topic.

'On our way back to Sumpini, I need you to drop me in Damongo then continue onto Sumpini yourself. Pick up Dr Cuddy then return to the house,' she said, taking his bowl and setting it atop her own. 'Do you think you can do that?'

'In the dark?'

'It's a straight line, Dr House. Can you handle a straight line?' she said forcefully, then her cheeks got red. 'I shouldn't be acting like this.'

'You're allowed to be angry,' House said and was immediately surprised by the trite platitude that he just allowed to slip from his mouth.

The trite platitude, however, seemed to be enough for Anna. She nodded. 'Go ahead and go to the bike -- I'll be out in a minute.'

He didn't wait for her to tell him again, standing up and immediately making for the door. As he stepped outside, he watched the last bit of orange dip below the horizon before walking through the circle to the bike. There were children playing near it, none of them children that he had cared for in the village. Because of this, they were excited to see him, yelling whatever the local version of 'obruni' was as they pointed at him. He paid little attention to them as he got on the bike, raising the kickstand and looking over to watch Anna exit the building and make her way toward them. When she appeared, they all rushed her and the group of them began chattering like what House associated with squirrels. She came to him and unzipped the side of her bag, pulling out a handful of Hacks cough drops and giving one to each of the children. Waving demurely to all, she got on the bike behind him, taking the cane he handed back to her.

Once they set off, the children followed after them, all yelling excitedly. Anna yelled something back at them and they stopped running, waving instead as they turned a corner and disappeared behind a millet field.

Almost exactly thirty minutes later, they entered the edge of Damongo and Anna did the same pulling of the shirt to guide him down the a few streets to get where she needed to be dropped off. He was not the least surprised when they stopped in front of St Anne's Cathedral and she alighted, leaning over immediately and removing her bag. She dug through it and pulled out a key, handing it to him.

'Can you find your way back to the main road?'

'Yes,' he said, taking the key and hanging the ring on it around his wrist. 'And it's a straight line from there.'

'Right,' she said, giving a half grin as she adjusted the bag on her shoulder; she bent over again and wove his cane through the straps for her bag, testing its security before continuing. 'I'll call Grace and let her know you're coming so Dr Cuddy will be ready to go. Just go back to the house and I'll be by in the morning to get both of you.'

He nodded, revving the engine of the bike as she stepped back from it. After doing a quick check for roaming livestock, he got on his way, looking in the small, grimy mirror to watch Anna turn toward the church before he took a curve around a building. As he drove through the backroads to make it to the main road again, he heard the unending cries of 'obruni' coming from roadside vendors, children and even men heading to the mosques for prayer. Once on the main road, he was able to speed up, the light on the front of the bike enough to help him dodge potholes in time.

When he arrived at the clinic about ten or fifteen minutes later, Cuddy was sitting on the stairs with the dogs. He didn't make a move to get off the bike, so Cuddy bid the dogs adieu and walked to him, giving him a good look up and down.

'Christ, you're filthy,' she said with a laugh as she reached the bike, but she couldn't really talk -- she also looked a bit grimy and had an iodine (or was it Mercurochrome?) stain on the edge of her shirt. 'Did you find any pattern?'

'Other than Natalie Chase has a penchant for killing?' he asked, and she raised an eyebrow. 'No, not really.'

'Please tell me you'll expound on that topic.'

He gave a vague nod behind him. 'Back at the house.'

She returned the nod, reaching out and taking the cane from the makeshift holder Anna had rigged. Holding it, she slipped on behind him, setting it between them as House turned the bike around to point the right direction. As they started back toward Damongo, Cuddy didn't hesitate to wrap her arms around his waist and press the side of her face onto his back with a long yawn. He unconsciously squeezed at her left arm with his left elbow, but neither seemed to notice it.

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A/N: Just a random aside to thank you for your reviews!


	16. Chapter 15

A/N: Long delay! I've been busy with a combination of nursing school and fighting Scientology -- you know how it is. As a thank you for my patiently waiting readers, the second part of this chapter is rated mature.

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Anna stole House away early the next morning, practically right as the sun was rising. He didn't seem pleased by this, yawning theatrically when she walked in front of him as the two of them walked out of the Damongo house. Cuddy had watched him get dressed from the bed, her eyes half-open and her hand lazily draped where he had been laying previously. When she sat up to watch them leave, her arms wrapped around her bent knees, she was leaning forward far enough to see Anna standing in the antechamber wearing a casual dress rather than the nurse outfit in which Cuddy was accustomed to seeing her. After they'd already left the house and the door had tapped closed, Anna made a u-turn and yelled into Cuddy that she'd be back in about an hour, so the older woman needed to get ready to go into town. Once the engine of the motorbike blurred into the other sounds of the town, Cuddy reluctantly got up and dressed.

Anna returned by trotro, her precarious position as a passenger on someone's knees by an open door evidenced by the red dust caked down her front. She let herself into the house, walking past Cuddy in the kitchen to go into the bathroom and wash up a bit. When she returned, Cuddy was by the door with a hoboesque bag slung across her chest. Anna smiled, leading Cuddy out into the courtyard before locking the door and skipping ahead of her. Once past the gate, Cuddy realised that it was a lot busier today than other couple of days she'd experienced in the area.

'It's market day,' Anna explained after noting Cuddy's raised eyebrows. 'I thought you'd be more interested in it than Dr House would be.'

Cuddy didn't have time to respond as Anna pulled her closer to the edge of the road, the two of them walking along the wall of a drainage ditch as a bus and trotro passed one another in the narrow road. Huge amounts of dust were kicked up by the movement, enough that Cuddy could feel some of the crunch between her teeth. Anna pulled two handkerchiefs out of her pocket and handed one back to Cuddy before tying the other surgical-style over her mouth and nose. They walked along in silence, neither wanting to keep her mouth open for extended periods despite the shield. Cuddy looked down in the ditch at the random things clustering together in it: stagnant water, discarded wrappers, tiny chicks. As they came into the more commercial district, they saw groups of orange-and-brown-clad students buying salt-caked hardboiled eggs before continuing to class, girls walking about with perfect lines of peanuts piled on metal plates balanced on their heads, men considering the machete selections at hardware stores and women fanning themselves as they sat at the front of stores filled with sundries.

With Anna, people were more willing to leave the two women alone, Cuddy not receiving a single marriage proposal all the way from the house to the market, a new record. People nodded at them, waved, yelled 'sister' at Anna -- this seemed a perfect moment for Cuddy's conversation with House the night before to come into play.

'House told me a bit about yesterday,' she began open-endedly.

Anna stopped and grabbed Cuddy's wrist, stepping widely across the drainage ditch and leading her to an area between two buildings that was occupied by a sole goat. It bleated at them then wandered off.

'What did he say to you?' she asked harshly as she pulled the handkerchief down to her neck, not yet letting go of Cuddy's wrist.

'That you were very uncomfortable during it,' Cuddy said sotto voce as she did the same. 'I wanted to make sure that you were alright.'

'Oh,' she said, shrinking back a bit as she dropped Cuddy's wrist. 'It's just not something I'll ever get used to, but at least Natalie has the decency to not discuss it later.'

'Decency isn't one of House's strong suits,' Cuddy replied dryly. 'He's just insanely curious about what makes you behave that way.'

'Like a human?' she asked, the vehemency of the statement incongruent with her tone.

She pinched her lips together ever so slightly. 'He vaguely wonders why you haven't been excommunicated, as it seems you're a "super hardcore Catholic".'

Anna rubbed her left forearm. 'The bishop is kind enough to look the other way either because of my history with the Church or the importance of the work we do.'

'History?'

Anna tensed her jaw slightly as she fingered at a place on her blouse -- the faint outline of the cross on her rosary was obvious when she pressed on the fabric. 'Does it matter?'

'No,' Cuddy replied, again quiet. 'Just curious about that.'

They stood in silence for a few moments before Anna turned back toward the road and took a few steps. Cuddy was about to follow before rolling her eyes to herself and sighing lightly.

'And why Natalie calls you "sister",' Cuddy said after Anna.

The younger woman stopped but did not turn around. 'Everyone calls women "sister" here.'

'Not the way Natalie was saying it,' said Cuddy, suddenly feeling a bit like House.

Anna turned and strode back to Cuddy. 'I was a postulant before coming here. Does it make you feel better knowing that? Does it make you feel better knowing that the reason the bishop doesn't stop me from doing this atrocity or why he hasn't made the move to begin excommunication is that I promised him that I wouldn't attempt to join the Sisterhood upon my return to America? Does that answer Dr House's question?'

Cuddy paused before nodding. Anna took a deep breath before turning once more and making it to the road before Cuddy followed. They continued walking in silence toward where the largest group of people were turning, very obviously the location of the market. When they began being surrounded by a large amount of conversation, Anna slowed down to fall back with Cuddy.

'And she specifically does it to make fun of me,' Anna replied softly. 'She likes to remind people of what they've lost so she doesn't have to think about her own losses.'

'Why do you continue working for her?' Cuddy asked, awkwardly reaching over to touch the back of Anna's hand.

'The same reason anyone works with Dr House,' Anna said. 'She's a talented physician.'

There was really no comeback to that, at least not one that Anna would fully comprehend, so Cuddy just nodded placidly as they entered the gated area that was the market.

---

The remainder of the day was pretty uneventful, Anna falling back into her normal, accepting self once she started speaking something other than English. In a move that seemed vaguely like a practical joke, Anna introduced her to a 'food' that looked like grey bullets -- Anna took a small bite and offered it to Cuddy, the Ghanaians and Anna laughing hysterically at the face Cuddy made in response to the horrid coal taste that flooded her mouth. After that, she made a good point of gathering specific items for their dinner, so by the time House returned on the motorbike as darkness was falling, the house was filled with the smell of _akoko nkatse nkwan_, or groundnut soup, and _tatale ke aboboi_, or fried plantain cakes.

House was surprisingly quiet and uncomplaining about his day spent at the clinic. Over dinner, the three of them spoke on light topics such as the weather, the things available at the market and some tourists they saw at market who were attempting the American female meld with Anna and Cuddy -- their attempts failed when Anna began chatting in Gonja to a market woman. Anna informed them that being able to do that was actually her favourite thing about being multilingual, a determination that House agreed upon. After they all cleaned the kitchen, Anna and House walked outside so that House could give the nurse report before she returned to the clinic. At about 7:30, Cuddy heard one of their neighbours walk into the courtyard and discuss something with Anna, and within a few minutes, the two of them had left on the motorbike.

The lights went off early that night, so rather than wasting the batteries of their iPods and flashlights, House and Cuddy called it a night, both laying down after a mostly blind walk to the bedroom and dim flashlight-lit change into pyjamas. House was on his back, his hands behind his head, as Cuddy curled on her left side. Although both tried to feign sleepiness, their lies didn't get them very far into a good state of somnolence. House sighed theatrically.

'So what did you learn about Miss Anna Cader?' he asked and she heard his head rustle against the pillow.

'More hardcore Catholic than you described,' she replied, not turning toward him.

'How?' he asked audaciously.

'She was studying to be a nun.'

'Damn,' he replied with a light chuckle. 'That is pretty hardcore.'

After an extended silence, she spoke again.

'She managed to avoid formal excommunication by agreeing to drop her attempt to be a religious sister. I feel sorry for her.'

'Why?' he asked. 'She escaped a life's worth of pointless religious servitude. She should be thanking God for euthanasia and Natalie Chase.'

She finally turned. 'It was important to her. Don't you understand that?'

His silence was actually comforting to her -- when he was silent, it was typically a sign that he knew he'd gone too far, some sort of odd penance for being a total ass. What was more surprising to her was what came next.

'I'm sorry,' he said. 'And I'll apologise to Anna.'

She turned her head sharply to stare at him in the darkness.

'What?'

'I think her religion is full of contradictions that only idiots could follow, but that doesn't mean it isn't important to her.'

Another long pause. '... what?'

'Do you really need me to repeat it again?'

'You're actually going to _apologise_ to Anna?'

'As a matter of survival,' he responded with a shrug. 'She knows the language, the customs--'

'No, just keep it at that. You're apologising to her.'

'Yes,' he replied. 'I'm apologising to her.'

'In the morning?'

'Yes.'

She laughed lightly, and he could imagine the lingering smile on her face. The sudden relaxation felt like something that should be taken advantage of, so he bravely breeched something that had not been seriously breeched in recent history.

'Let's have sex.'

He heard her head turn once more. She raised one eyebrow questioningly.

'Are you serious?'

There was a rustling as he reached over to the nightstand and fumbled, grabbing his flashlight and holding it up campfire style, revealing a completely sober face. 'Do I look serious?'

She looked up at the ceiling with a groan. 'It's too hot to have sex.'

This was an unexpected slight acceptance. 'Turn the fan on.'

Another small laugh. 'The power's off.'

'Anna has much to learn about the world of sexual intercourse now that she's accepted her return to real life,' House said quickly with raised eyebrows harshly illuminated by the flashlight. 'Ask her to come in here and beat a fan for us.'

'She's not even here, House.'

After a moment, she sat up and he expected her to get up to wander to the bathroom, but instead she pulled her tanktop off before leaning over him and dropping her mouth to meet his. At first, he seemed completely stunned, letting the flashlight roll out of his fingers and land on the rug next to the bed with a thud, but as she pressed deeper, he met her kiss in ferociousness. His fingers dug into the skin over her scalpulae, a move which made her moan against his lips. Breaking the kiss, she sat up.

'If you're serious about this,' she said, reaching back to throw the tanktop off of the bed. 'Take your pants off.'

'This... is _awesome_,' he replied, already throwing his legs over the side to pull his pyjama pants off and throw them onto the floor.

By the time he'd removed his pants and retrieved the flashlight from the floor, she'd already thrown the boxers she was wearing onto the floor. Sitting on her knees, she grabbed one side of his face and licked the other. He looked at her in the half-light created by the flashlight on the nightstand as he picked up his leg and turned around.

'You know...' he said, settling back against the headboard as he looked her up and down. 'I'm actually sort of scared.'

'You should be,' she responded with a raised eyebrow. 'Top or bottom?'

He blinked a few times. 'Is this a game?'

'What do you mean?'

'Are you going to mount me and then say "haha, big joke" and make me go, um... _sulk_ in the bathroom?'

A single beat. 'Top or bottom?'

'Sulk means masturbate.'

With a sigh, she dropped to her side then rolled away from him. 'If you don't want to...'

'I knew it!' he said, cupping his hands over his manhood. 'You are amazingly cruel.'

He reclined more, a sullen look on his face, when she suddenly turned around and in a fluid movement sat on his stomach.

'Ah, lifeguard Cuddy,' he managed before she open-handed smacked him across the face.

'I'm going to roll back over to my side,' she said, leaning over his face, her hair falling on either side of him. 'I want the sexual tension to dissipate and apparently the only way that's going to happen is if you bed me again.'

The underlying tone told his subconscious that this wasn't the actual reasoning for her but rather something likely related to a stress response. Considering it was also a stress reliever for him, his mind permitted him to play along.

'Or will leave me wanting more.'

She raised her eyebrows before getting up to her knees again and rolling to her side, laying prostrate beside him. He sat up, looking down at her.

'I kind of don't want it now,' he said in a nearly childish voice.

'Exactly,' she replied. 'All talk, no action.'

With the windows open, they could hear one of their neighbours have a coughing fit, and once that stopped, the only sound was them breathing. In the incandescent glow, he saw her roll her eyes and she was about to turn when he reached out and grabbed the opposite side of her face. She looked up at him as he leaned over, dropping his hand to her chin to tip her lips toward him before leaning down far enough for his lips to meet her own. His right hand ran fingertips down her cheek and neck, the sensation causing goosebumps down her arms. He reached her breasts and cupped the right one, his index finger making circles around the nipple. She smiled against his lips.

He broke the kiss for a moment. 'Can we play doctor?'

'Shut up,' she said breathlessly as he strengthened his offence against her breast; their lips met again, more aggressively this time.

He lifted his hand from her breast, reaching over to position himself over her better. She reached up and took his face in both hands, running them up to curl into his hair. The kiss broke with him pulling away, his teeth lightly holding her lower lip between them. Shifting to his right elbow, he reached out with his left hand and absentmindedly played with her left breast as she looked down at him, one hand reached out to cup his jaw.

'Honestly,' she said, rubbing her index finger against his stubble. 'I've never been one for foreplay.'

'I _can_ do a wham-bam, thank ya ma'am.'

'If I remember correctly, it was even faster than that.'

'Ouch,' he replied, pushing himself back up into a sitting position and looking down at her amazingly well-waxed vagina. 'That is just _art_.'

Crawling his fingers down her stomach, he slipped his middle and and index fingers into her labia, quickly finding her clitoris and rubbing teasingly around it. A wave of endorphins hit her and she closed her eyes with a smile. After determining that yes, this was going to _indeed_ be an easy stimulation session, House carefully sat up and straddled her, placing his hands on either side of her hips.

'Shall we do this then?' he asked.

'Go ahead.'

'This is sort of scientific.'

'I don't remember you talking this much before,' she said, looking at him with furrowed brow. 'Quit stalling.'

'Give me a minute,' he said in a half-voice. 'The Vicodin kind of...'

'Oh, you have _got _to be kidding.'

'Just let me stare at the funbags for a bit.'

Spreading her arms out, she let him see the full expanse of her chest. He reached out, taking both in his hands before slowly leaning down and pressing them together, placing his face right between them. He turned his head to the side and took one nipple into his mouth, biting it lightly. She moaned, her body arcing slightly against him as she reached down to grab the sheets. As he continued, she ran her fingers lightly down his side, making him shiver and let out a gracious sigh. As she dropped her hand back to the bed, he sat up and repositioned himself before slipping into her.

'Really, House,' she chided. 'Is that all you've got?'

With a half-grin, he reached his fingers back down to her clitoris and began quickly making circles around the erectile tissue. She closed her eyes again, moaning lightly, her muscles growing tense. One of her legs curled up to latch around his as he dove down and their mouths met once more. She reached out, taking him into her arms and curling her fingers violently through his hair as rhythm built. She was the one who broke the kiss, forcing him to nibble at her ear and neck as she turned her face to the side and moaned with a higher pitch. He felt her muscles growing even tenser, her body arcing against him strongly as her fingers slipped down and dug into his back. Biting her lip, she pulled him closer, her abdominal muscles taut. Inside of her, he could feel the pressure building as she threw her head back against the pillow, no longer able to hold her breath. All at once, he felt her flood with ecstasy and she moaned loudly, turning her face to stifle the noise in his neck.

'Greg,' she murmured, her lips craned up to his ear.

That one word, moaned so artfully, was enough to set him over the edge. He laced his arms under her shoulders, one hand behind her neck as he raised her head slightly and caught her lips once more. She hit the apex of her orgasm at nearly the same instant as he did, and they continued kissing as he settled motionlessly atop her. They pressed their foreheads together, Cuddy biting her bottom lip before they gave each other a few more gossamer kisses.

What felt like an eternity passed before he sat up, his hands never fully leaving her even as he settled down on his side of the bed again. She turned to face him, her breath still in light sighs as she reached out to hold the side of his face and press her nose against it, kissing along his jawline as he snaked his arm around to go under one side of her waist and cradle his hand in the other.

'So,' he said, also slightly breathless. 'Was it better this time?'

She laughed against his jaw before she moved her lips up to his ear. 'Only because I haven't had sex in a long while.'

He returned the laugh, looking at the ceiling before reaching over and turning off the flashlight. Once the descent into darkness was complete, he too turned over onto his side and continued kissing her.


	17. Chapter 16

The call came in at around 4:50 in the morning.

Anna, fast asleep, was jarred awake by her mobile skittering across the nightstand, its neon blue harshly illuminating the powerless clinic. Reaching out blindly, she sighed before squinting open one eye to check the number, expecting it to contain the string 806, as her father had not yet managed to grasp the idea of time zones despite both her living in Ghana for a long time _and_ his post-doctoral education. She blinked a few times to bring the numbers into focus and was surprised to instead see 226, a triad of numbers which took her a moment of groggy pensiveness to remember as the calling code for the country of Burkina Faso. It took only a few moments for this knowledge to click in her head, at which point she shot up in bed, frantically pressing the green phone icon with both thumbs on the very last possible ring. She raised it to her ear, one hand pressing it violently to the side of her head and the other cradling the bottom as one would a child.

'Anna Cader,' she said in her best attempt at sounding awake.

There was some static, the result of Burkina Faso's far less stellar telecommunications system.

'Natalie?' she hazarded.

'No, but this does regard Dr Chase,' said a male voice with a strong Québecois accent. 'My name is Olivier Vioget, a physician with MSF.'

'We've spoken once before, Dr Vioget,' Anna replied. 'I'm the NP who works with Dr Cader.'

'One of the nurses here had this as a secondary contact number for Dr Chase,' Vioget replied. 'She has not been answering her primary number.'

Anna froze. 'She's not there with you?'

'That's what I called to ask about,' Vioget continued. 'We were expecting Dr Chase to arrive yesterday afternoon at the latest, but she has not arrived nor have we heard from her.'

'She left Sumpini on Friday morning,' Anna replied. 'I haven't heard from her since then.'

There was an extended silence, both considering what could be said next.

Anna sighed into the phone. 'Have you only tried her mobile?'

'Both the mobile and satellite numbers have failed to go through.'

By this point, Anna had slipped the lower hand from the phone and was gnawing at a hangnail.

'I forget, where was she supposed to meet you?'

'Right over the Côte d'Ivoire border near the Komoé River. Are you familiar with the area?' he said, then waited for Anna to grunt affirmatively before continuing. 'We were to meet her in the delta where the Komoé and Létaba meet.'

In her head, she visualised her well-worn West Africa map that she knew to be hanging in her room at the Damongo house. By her mental estimation, the area where they were to meet was less than six hundred kilometers from the clinic -- even with bad roads, the trip shouldn't have taken more than sixteen hours, especially considering the moderately high quality of the vehicle they were driving. Anna felt an iciness in the pit of her stomach that reached the lowest point of Kelvin.

'We haven't heard of any accidents between here and Bouna, but I can't promise anything between Bouna and Ghana.'

'Market day was yesterday and none of the sellers from Côte d'Ivoire mentioned anything -- they would be coming from the direction of Bouna,' Anna replied. 'They know us; they would have mentioned something if they'd seen it.'

Anna considered this statement for a moment.

'I know she'd at least passed the border into Côte d'Ivoire,' she said in a moment of clarity as she grabbed her flashlight and began to walk across the room to door, laying her hand on the knob. 'One of the sellers in the market mentioned having seen her at the police checkpoint on Friday afternoon.'

'She should have been here yesterday morning then,' Vioget said, vocalising what they both knew.

She had started turning the handle to go out when a force came from the other side causing Anna to drop her flashlight and jump back from the door as it flung open to reveal one of the night nurses, her own mobile clutched in her hand. She flashed her own torch in Anna's eyes unintentionally.

'Sister Anna,' she said. 'I just received a call from Innocent. He needs to speak to you.'

Anna stared openly at the woman before speaking in a low tone to Dr Vioget. 'One of my nurses just came to tell me she's received a call from the assistant accompanying Dr Chase. I'll keep you updated.'

She didn't wait for a response from the doctor, opting instead to quickly end the call and reach out for the mobile in the nurse's extended hand. She brought it to her ear, the locked gaze between her and the nurse acting as though they were physically supporting one another.

'Innocent,' she said, her throat suddenly dry. 'Where are you?'

'We're at the police checkpoint at the border,' he replied hurriedly. 'Both mobiles are dead, so this was the first place that I was able to stop and ask for a connection. We're returning to Sumpini.'

'Why were you unable to meet with Vioget's team?'

He took in a deep breath. 'Dr Chase has fallen very ill, Sister Anna.'

'H-How ill? What do you mean?'

He didn't respond, instead answering someone in French before coming back to the phone. 'We've been cleared through the checkpoint. We should be there in less than two hours.'

'What's wrong with her, Innocent?'

She didn't realise she was holding her breath until the mobile sounded the ended call beep and she jumped, bringing the phone down to stare at it. The nurse in front of her took a step forward and delicately removed the mobile from Anna's hand.

'What do we need to do?' she asked quietly.

Anna moved her mouth soundlessly, blinking at her empty hands as she thought. After taking a deep breath, she met eyes with the nurse again.

'Adzoa,' she articulated. 'I need you to get at least two more nurses and three assistants to run morning rounds now. We don't know what to expect, so I want everything to be out of the way.'

'How soon will they be here?'

'They're at the border now, so less than two hours,' Anna replied, turning back to the room to grab a jacket and sandals. 'Gather everyone and get started; I'm going to Damongo to get Dr House and Dr Cuddy.'

Before the final word was out of her mouth, Adzoa was already on the phone calling the needed people. Comfortable with the organisational ability of her employees, Anna left the room, striding across the courtyard as she looked down at her watch. It was just now five o'clock, and as she walked down the stairs, the electricity clicked back to life. It was perfect timing for transportation too -- it was Sunday, so sunrise services had a specific time. Within two minutes, she'd managed to catch a trotro and was on her way to Damongo.

---

The sun was rising when she reached Damongo, the trotro dropping her off at the main road rather than carrying her all the way to the Catholic church. The driver did not make her pay.

She kept slipping off of her sandals as she walked quickly toward the house, so by the time she arrived at close to 5:45, her feet were absolutely filthy with dust and caked mud. Their neighbours were already awake, all getting ready for Mass, but they paid no attention to Anna as she creaked open the gate and walked across the courtyard quietly. The door to the house was unlocked, thus making her hasty entrance even easier. Without much thought to the sleeping of the two doctors, Anna flung her shoes in the general direction of the couch and strode through the main room and into the antechamber before the bedrooms and bathroom. She was paying little attention to her surroundings and because of that, she had already stepped through the open bedroom door and opened her mouth before looking at the bed. She blushed, catching herself right before speaking.

House was lightly snoring, his face toward the ceiling as Cuddy laid on her side, curled against him with the edge of the sheets clutched in her left hand. Her face was resting in the crook between his neck and shoulder. There was something precious there, to be sure, but Anna was more embarrassed about her haste causing her to intrude on their privacy. Looking back at the floor, she took a single step back, pulling the door mostly closed and waiting about ten seconds before knocking loudly.

'Doctors?' she called, knocking more.

There was the rustling of sheets and the sound of Cuddy yawning.

'What time is it?' House murmured at Cuddy.

'I don't know,' she sighed back. 'Early.'

'It's almost six,' Anna said. 'Something--'

'Six?' House interrupted. 'It's Sunday; we have the day off.'

'Something has happened and I need both of you to come to Sumpini with me,' she continued forcefully.

There was more rustling followed by the slap of bare feet on the floor as one of them searched for clothing. It was Cuddy who appeared a minute later dressed in a rather wrinkled Harvard t-shirt of Anna's. She leaned at on the door frame and looked at Anna as House sat leaning forward on the bed, his middle finger and thumb rubbing the sleep crust at the corners of his eyes.

'What happened?'

'I don't know the details, but I was woken up by a call from one of Natalie's MSF colleagues -- she never made it to Burkina Faso, she replied, focusing on Cuddy instead of the now-wandering House. 'Then Adzoa got a call from Innocent, Natalie's assistant, saying that Natalie has fallen ill again and they're coming back here. They were at the Côte d'Ivoire border about forty minutes ago.'

'You weren't given any symptoms?' House asked, coming up behind Cuddy with something akin to a toga now draped about him.

'Innocent said they'd cleared with the police and then he hung up,' she replied with a rather sad sigh. 'Listen, I need to go somewhere in town -- you can make it to the clinic, right?'

'Yes,' House said.

'When you get there, Adzoa should have gathered a pretty good number of nurses and assistants. They'll already be doing rounds, but if you could go through with them and see if there are any issues, that would be wonderful. See if there are priority cases that need to be dealt with STAT, I wasn't able to take any sort of report yet this morning, so I don't...' she started, drifting off before consolidating her thoughts again. 'I just want everything _completely_ squared away in case we need to either give Natalie special care or take her to Tamale or Kumasi.'

She opened her mouth as though she was going to say something more, but instead she walked between them, taking a right turn and opening her wardrobe. She pulled out a dress before leaving the room again and turning toward the bathroom. Without a word to them, she closed the door behind her. They both stood there until water began running, at which point House whipped the sheet off and threw it toward the bed. Cuddy rubbed her eyes a bit before going to the same wardrobe and pulling out one of the dresses that had been made for her.

'Motorbike, Cuddy.'

For a moment, she thought it was unwelcome innuendo but then her brain woke up ever so slightly more and she remembered that yes, they _would_ be riding a motorbike to the clinic. She grabbed a pair of pilfered Natalie pants, pausing to look at them as the gravity of the situation dawned on her. Slowly putting them over her arm, she picked up a Natalie shirt, Natalie jacket and Natalie sandals before turning and placing them all on the bed halfway ceremoniously. They stood in silence, both perhaps still too tired to begin discussion of any sort. When the water stopped, they stood straighter and looked toward the antechamber -- once Anna had exited the bathroom and, in short time, left the house without a word, they began migrating toward the bathroom. Cuddy stopped outside of the door.

'Go ahead.'

He paused, waggling his eyebrows. 'Not together?'

She gave him a cold look. 'Just get moving.'

---

Anna showed up only ten minutes after they did, but regardless, everything was close to completion thanks to the very competent staff of the clinic. A mere, harried fifteen minutes passed before they finished what was nearly a day's worth of work. One of the nurses stayed in the office the entire time making calls to homebound patients explaining that they would not be seen until at least tomorrow -- she offered no details but no one really asked, as it was Sunday and everything was much slower, people expecting less on the Sabbath.

The cold of the morning was close to breaking when Anna received a phone call from the very close town of Busunu -- a parishioner of the Catholic church had passed the Defender on his way to Damongo for services. He wondered why Innocent was in the driver's seat and Natalie was nowhere to be seen, so Anna made up some insignificant lie and hung up.

'She's laying down in the back of the Defender,' Anna reported as she dropped the phone atop the table in the courtyard where House and Cuddy sat. 'They're in Busunu, so I give them ten minutes at the most.'

After informing them, she gathered all of the clinic staff in the courtyard and began a speech in Twi. Although House remained sitting at the table, Cuddy stood and walked to the stairs to look out at the road. She was the first to see the Defender and called Anna who in turn began pointing people in different directions, a group of three isolation gown-clad employees with an old stretcher following her past Cuddy and down to the area in front of the clinic. The Defender turned off of the main road and was quickly thrown into park by the Ghanaian man who jumped out of the vehicle before the engine had even stopped. He ran around to the back of the car and threw the doors open as Anna's group gathered around. Cuddy couldn't see all of their movements from her vantage point, but the taller House could as he walked up behind her.

'She looks horrible,' House said rather honestly and solemnly.

As they came around with the stretcher, Cuddy found herself stunned at the amount of blood that two of the assistants had managed to get on the fronts of their isolation gowns. Natalie's head was lolling back and forth, her mouth hanging open as she blinked slowly. Anna walked alongside the stretcher, reaching over and trying to wipe at Natalie's bleeding nose as they moved. They walked carefully up the stairs, House and Cuddy both able to see now that her face was ashen and sweaty, the combination of blood loss and fever very apparent. As they came to the top of the stairs, Natalie took a sharp breath and reached out to weakly grab the edge of House's shirt. For a moment, he thought it was odd that she would choose this exact moment to be angry at the two of them for remaining in Ghana, but instead, she was looking at him imploringly.

'Don't tell Rob,' she murmured exhaustedly through chapped lips. 'He'd take too much pleasure.'

House gave her an odd look and tipped his head as she closed her eyes again, swallowing before coughing dryly. House looked at Anna and Cuddy in turn, both seeming as confused as he was. The assistants began to take her away when House noticed a glimmer at her chest and stopped them. Reaching down, he grabbed onto a metallic charm and pulled at it harshly, ripping it from the chain around Natalie's neck before giving the assistants a nod. He glanced down at it for a second before handing it to Cuddy. She ran an index finger over the embossed caduceus.

'Our first set of medical clues about Natalie Chase,' House said. 'Let's get to work.'


	18. Chapter 17

The day had become very hot and humid with storms brewing on the horizon. Cuddy could smell the rain as she stood by the window in Natalie's room, pressing her face to the levels of slatted glass to breathe in the fresh air rather than continuing to inhale the combined scents of the lidocaine, silver nitrate and antibiotic ointment that had to be used to stop Natalie's bleeding nose. There was still the metallic smell of blood hanging around the room, proof of prior bleeding obvious on the isolation gowns of the healthcare workers, some crusted blood clumping in Natalie's hair and the pile of Natalie's discarded clothes in the corner in a biohazard bag. She was asleep now due to a perhaps too large dosage of codeine used to bring relief from sudden spasms of muscle pain and a migraine that left her screaming -- she was still breathing, so that was all that mattered to them.

For the last fifteen minutes, House had slowly paced back and forth in the room speaking to himself. When he stopped, she turned around and saw that he'd moved to the foot of the bed, staring intently at the unconscious woman. Adzoa was sitting on a stool next to the bed as she combed the ends of Natalie's hair. When she combed through it, the blood flaked off onto a damp towel she'd placed under the hair. Once she'd finished, Cuddy wandered over to the bed and stood next to House. He was turning over the teardrop-shaped Medic Alert pendant continuously as he mumbled.

'Asthma, epilepsy, HIV, latex, penicillin, sulfa, cephalosporin...' he recited, his voice obscured not only by the low volume but also by the face masks that all of them wore.

A breeze blew into the room carrying upon it the smell of rain that Cuddy had noted earlier.

'It's going to rain,' Anna said rather matter-of-factly from the school desk she'd set up to one side of Natalie's bed. 'It's been raining too much.'

'Rain,' House muttered, looking up at the ceiling in thought before going back to his recitation.

Anna glanced up at him for a moment before crouching over her work again. She had a well-worn box of Sparks and Taylor's nursing diagnosis cards set on one of the corners of the desk and the NANDA list of approved diagnoses taped on the wall beside her. Although Cuddy was utterly certain that Anna was far beyond the need for cheat sheets, the nurse seemed to cling to them. She seemed distracted whenever she wasn't staring intently at the cards, none of which had pointed corners any longer. House stopped turning over the pendant for a moment before walking to the door and leaning out.

As he left the room, Cuddy set her hands on the edge of the bed and looked at Natalie. She seemed more frail than she remembered, but she wasn't sure if it was due to her current health condition or if she'd just seemed more imposing the one time they'd met her before. Her pale arms were mottled with bruises and a rash she didn't remember had formed across the right side of her face. With none of them sure of a diagnosis at this point, they had simply decided to work on returning her to a moderately healthy fluid status, so she had an IV port inserted into her left arm. Blood had been drawn from the arm prior to the insertion of the IV, so there was bruising at the crook of her arm. At first, Anna had put an electronic BP monitor on Natalie's right wrist, but she realised after three blood pressure checks performed over a thirty minute period that there were bruises forming over the bones of her wrist -- they decided as a group that they would only attempt q2hrs and prn for vital signs as long as she seemed moderately stable.

'So is Rob the name of the Chase who works for you?' Anna asked, her fingers laced through her hair as she spoke, not looking at Cuddy.

'Robert, yes,' Cuddy replied, sighing before walking around to sit on the stool where Adzoa had been.

'Why would he enjoy having Natalie be ill?'

Cuddy considered this for a moment then shook her head. 'I have no idea.'

'What does he look like?' she asked, looking up at Cuddy with this question.

'Blond hair, blue eyes,' Cuddy replied with a light laugh. 'Nothing like Natalie.'

'It has to have been a divorce,' Anna said with a slight air of disapproval. 'A really nasty one that was bad enough that she hasn't mentioned it.'

'I guess we'll have to ask her when she wakes up.'

They stopped talking, Anna focusing on watching Natalie's chest rise and fall to the beat of bradypnoea. They both looked up as House walked back into the room followed closely by Innocent, who was carrying a white board and tripod that the clinic used for informational health seminars for the community. Once Innocent had set it down and left the room again, House pulled out a black dry erase marker with a flourish and began writing down symptoms that Natalie had displayed. In one corner, he wrote down the mantra he formulated from the pendant that had disappeared into his pocket.

'Why don't we know what medications she takes?' he asked, a sharpness to his voice. 'She has to pick up the prescriptions somewhere, have the bottles somewhere.'

'The medications around here are dispensed in baggies and Natalie tears the labels off,' Anna replied.

House turned around, spinning the marker in his fingers. 'All drug guides have sets of photographs used to identify medications. Compare her pills to the ones in the book.'

'The pills here don't match the ones in the book,' Anna replied in a frighteningly calm tone. 'We get the majority of our drugs as Indian generics.'

'Wonderful,' he said, his voice dripping sarcasm.

He looked over at Cuddy but quickly averted his stare when their eyes met. Rain began falling outside of the window and before long the occasional tap on the glass and roof became a steady pounding. A fine mist of water created a wet film on the slatted glass and soon enough a puddle had formed at the window. None of them moved to do anything about it.

'I don't know enough about tropical medicine,' House said in a half voice as he stepped back from the white board.

Cuddy threw an incredulous look in his direction but said nothing. He crossed his arms and stared at the board, reaching up after a moment to tap the end of the marker on his lower lip.

'This would be easier if you'd just engage in some small talk with her, Cader,' House said with a bit of an acrimonious tone as he turned to face them. 'How do you somehow manage to avoid knowing any personal or medical information about a woman that you've known and lived with for over a year?'

'Sorry we can't all be as prying and obnoxious as you, Dr House,' Anna said lightly as she continued writing; this time, she did not apologise.

'As a nurse, you should be more intuitive,' House replied in the same tone as before. 'You should know how to take a fucking history.'

Anna looked up at him, her jaw set. 'I'm not her physician, so there was no--'

'You're not a physician,' House snapped. 'You'll never be a physician; you're a nurse.'

'House!' Cuddy yelled angrily.

In an instant, Anna was to her feet, taking one edge of the desk and shoving it, sending the piece of furniture crashing to the floor. The cards that had been on the surface skid in piles across the floor with a light woosh that mimicked the sound of the rain. With continuing anger, she ripped off her face mask to reveal reddened cheeks.

'I have been so _exceedingly_ accommodating to you,' she said, emphasizing the fifth word with an extended hiss.

'You have a host of tropical disease experts in the countries surrounding this one,' House replied, taking a step toward her as he too ripped off his mask. 'You have connections in Doctors Without Borders. Why the fuck would you send for me?'

'I didn't _send_ for you,' Anna said in a louder voice. 'I called for input because you're considered one of the best. I _never_ intended for you to come here.'

'Did you even bother looking at this?' House said, ignoring every word she said as he held up the pendant. 'Do you actually know anything?'

'Why look at the necklace when there's no emergency? I haven't administered medications to her, so there's no need to clutter my brain with Natalie minutiae. Normal people don't feel the need to pry into every detail of the lives of the people around them!' Anna replied as she threw her arms about theatrically and took three good strides toward him. 'You're a stalker. No, you're worse than a stalker. You stalk your employees, you stalk your employer, you torture information out of people you don't know--'

'Why aren't you defending me?' House interrupted, turning to Cuddy.

'What is there to defend?' Cuddy replied, suddenly realising that at some point during the confrontation, she'd taken ahold of Natalie's hand, which had grown clammy. 'There is absolutely no reason to fight over something that can't be controlled.'

'She could have controlled it by thinking into the future and gathering information.'

Cuddy was about to say something when Natalie's hand raised up. Everyone in the room focused on her, expecting that she had woken from her codeine-induced sleep, but instead her arm was twitching awkwardly upward as her half-open eyes focused on nothing, not even the sheets that she appeared to be looking at. Her arm raised as her head turned to the side before arcing back, both arms tensing as her eyes rolled back in her head. Anna was the first to respond, crossing the room frantically to rip the siderails up on her side. Cuddy was slower to react but managed to get the siderail up and padded with an extra pillow before Natalie leaned to her side, her body tensing and shuddering -- almost immediately after that, she when into clinical mode and grabbed the tank of oxygen that was braced to the side of the bed and used the plastic O2 tank key to open the regulator. Paying no attention to the liters per minute flowing, she reached over with a cannula in an attempt to get the oxygen as close to Natalie's face as possible to avoid hypoxia. Once she'd at least loosely gotten it behind Natalie's ears, she grabbed an ear bulb and started removing secretions from her mouth so that she wouldn't choke on her own saliva.

Assuring herself that Cuddy had the safety and airway issues handled, Anna frantically grabbed a capped syringe of diazepam and twisted off the top, letting it drop at her feet as she reached over and grabbed Natalie's hand, steadying it as she Luer-locked the syringe into the port closest to Natalie. She slowly administered it, not wanting the bolus to enter Natalie's bloodstream too quickly.

Despite Cuddy's attempt at oxygenation, Natalie's lips were losing their colour by the time the seizure stopped a little over two minutes later. As soon as she was motionless, Cuddy secured the cannula properly and adjusted the flow rate to two liters a minute. She pulled a pen light from her pocket and opened Natalie's right eye, checking pupil dilation before checking the left. Anna stepped back a couple of steps and fell into her chair, staring blankly at Cuddy doing a system assessment on Natalie.

Once Cuddy was completely certain that Natalie had just fallen into a postictal state, she too sat down. Both looked up at the decidedly sangfroid House as he scrawled 'seizures' on the board.

'Is it the epilepsy or whatever illness she has?' he asked mostly to himself. 'And did she go hypoxic that quickly because of a normal seizure state or the asthma?'

'Normal seizure state,' Cuddy replied as she looked over at Natalie again -- she'd returned to her normal colour.

'Are you sure?'

'I am,' Anna said. 'My cousin has epilepsy, so I've seen my fair share of seizures. It's normal to be hypoxic.'

'That quickly though?'

'She was already bradypneic because of the codeine,' Cuddy replied.

Anna looked at Natalie for a moment before glancing at her watch and beginning to count respirations. She looked concerned -- Cuddy had started counting at the same time and was displeased at a respiratory rate of eight.

'Codeine and diazepam.'

Anna nodded. 'I'll go get some naloxone.'

She'd been out of the room for about a minute when the warm sound of rain became the harsh patter of hail. Thunder started pounding as House walked over to grab a chair and pull it over to sit next to Cuddy.

'Any guesses?' she asked.

He glanced up at the board then back to Natalie, leaning over to rest his elbows on his knees.

'None.'

'None because you haven't formulated anything, or none because--'

'Epidemiology,' he replied, leaning farther forward to rest his forehead on his thumbs. 'I'm just not familiar enough with the endemic diseases of the area and that's hindering the aforementioned formulation.'

There was light moaning from the bed and both looked up as Natalie opened her eyes half-way. She went slightly cross-eyed to look at the cannula before reaching up and adjusting it lazily. Both were silent as they watched her; after a moment she turned her head and looked at them.

'What medications do you take?' House asked without prelude.

'What?' she susurrated.

'You have medical conditions for which you should be taking medication,' he replied, pulling out the charm and holding it by its bale. 'What do you take for asthma, epilepsy and HIV?'

'Nothing,' she started, closing her eyes. 'Nothing for... epilepsy and HIV. Elite controller.'

House locked his jaw for a minute -- he'd obviously been hoping for some drop in her elite controller status.

'What was your CD4 last time you had it tested?'

'Hasn't been tested in a year or so,' she replied. 'But it was around 1200.'

'Asthma medication?' Cuddy asked.

'Theophylline,' she said, slowly moving her gaze to Cuddy. 'And also bupropion.'

'The asthma,' House began. 'Idiopathic?'

'Both parents were smokers,' she replied quietly. 'Both died of lung cancer.'

Cuddy looked over at House and they wordlessly exchanged significant glances. Without a reply, he stood and walked to the board to write down the information he'd been given.

'Dr Cuddy,' Natalie said, and Cuddy looked over to see she had her eyes closed. 'I feel like I have a fever. Could you check?'

Cuddy stood and grabbed the thermometer from the table, pulling out the sensor and diving it into the box of sensor covers before putting it under Natalie's tongue -- even before the display read 40 Celsius, Cuddy knew she had a severe fever and already had her eyes on a syringe of paracetamol on the metal tray atop the table from which she had grabbed the thermometer. She'd depressed the plunger on the syringe halfway when Anna returned, naloxone in hand.

'Ignoring the other patients isn't beneficial to anyone, Anna,' Natalie said as Anna came up behind Cuddy and set the syringe of naloxone on the table.

'I'm sorry,' Anna said in a decidedly defeated tone.

'Tomorrow you will take...' Natalie started before taking a deep breath through her nose. 'You will take one of the doctors and do house calls.'

'Yes, Dr Chase,' she replied from behind Cuddy before coming around to the other side of the bed and righting the desk.

'So you're Rowan Chase's daughter,' House said from the white board.

For a moment, everyone thought that she had dozed off, but then she spoke decidedly laconically.

'Yes,' she said before letting her head drift to the side.

Once she'd laid motionless for a good thirty seconds, House laughed, the sound first blending into the falling rain but becoming increasingly louder. Anna and Cuddy both looked at him, Anna completely lost but Cuddy seeing all of the pieces fall into place. She sighed.

'No wonder he'd love her trials and tribulations,' House said almost ebulliently, flipping the marker in the air.

'Why?' Anna asked, turning to the more serious-looking Cuddy.

'Our Dr Chase's father left the family when Robert was young,' Cuddy replied, still watching House, who seemed poised to tell the rest of the story.

'Her mother has to have been the other woman,' House said as he caught the marker in both hands. 'God, it's juicy.'

'But unrelated to diagnostics,' Cuddy said in a warning tone as Anna opened her mouth. 'Why don't we take the white board to the office and you can work there for awhile so Natalie can sleep?'

'She'll sleep regardless,' House replied, but Cuddy was making her way over to him and picking up the tripod and white board.

When both of them had left the room, Anna slipped out of the chair and began picking up her cards, carefully laying the pertinent ones in rows as she returned to some sense of normalcy within herself.


	19. Chapter 18

They slept at the clinic that night, though Cuddy couldn't be certain if House had actually slept at all, as he was awake whenever she woke up. He'd been uncharacteristically quiet after they'd settled in bed, the quiet changing to an awkward clinging after about twenty minutes. He'd obviously thought she was asleep and was attempting to feign the same, but his non-sleep grip on her was enough to keep her up. Her only tracts of sleep were given courtesy of the whiteboard House had insisted on bringing into the bedroom -- Cuddy wasn't entirely convinced that he could actually read any of the moonlit words upon it without his glasses, an important piece of equipment that remained on the bedside table the entire night. Of course, it didn't matter, as she was convinced that he'd memorised the whole damn thing, a fact which was confirmed by the quiet murmuring he'd start up with every now and then.

She'd fallen asleep solidly at some random point during the night and woke up around 8:30 when Anna, who had spent the night in Natalie's room, came in to grab a new top to replace the mercurochromed one she'd been wearing. She'd left the door open, so Cuddy was able hear even more vividly the fact that it was raining yet again. She sat up, looking over at Anna as she pulled off the top and changed, not appearing to be in the mood for anything but perhaps fact-based conversation.

'Where's House?' Cuddy asked.

Anna didn't even vaguely seem to want to discuss House, but she was willing to humor Cuddy.

'He came into Natalie's room at 5:30 and demanded solo access to every book in the office,' she replied as she closed the drawer and began her way back to the door. 'I think he's locked himself in there, but I don't really care to check.'

After Cuddy had gotten dressed, she went to the door and lightly tried the handle -- he hadn't locked it, but she had a feeling he was making an attempt at getting into the zone by hunkering down with his commandeered books as others did rounds and took care of sundry tasks around the clinic. She joined in those tasks before finally hazarding an entrance into the office around 11, sitting silently across from him for nearly fifteen minutes during which he didn't even look up at her -- there was a growing hum of people around the clinic, but neither paid the sound much mind. He'd cast aside most of the books at that point, so Cuddy began taking them from him and putting them back on the shelf: _The PDR Pocket Guide to Prescription Drugs_, _Psychotropic Drugs_, _Dangerous Drug Interactions_, _Emergency Nursing Reference_, _Control of Communicable Diseases Manual_, _Manual of Emergency Care_, _Taber's Cyclopedic Medical Dictionary_, _Oxford Handbook of Tropical Medicine_, _Atlas of Tropical Medicine and Parasitology_, _Emerging Infectious Diseases: Trends and Issues, Davis's Drug Guide_, _Mosby's Diagnostic and Laboratory Test Reference_. Open in front of him was a well-worn copy of _Lecture Notes on Tropical Medicine_ -- by his elbow, he had an as-of-yet unopened copy of _Where There Is No Doctor: A Village Health Care Handbook_. Once she sat back down, he took off his glasses and squeezed the bridge of his nose as he sighed.

'It seems like I should have an answer by now,' he said, not looking up at her.

'You're not used to these diseases.'

'Board certified in infectious disease, Cuddy,' he replied halfheartedly as he put the glasses back on his face. 'I obviously haven't kept up on trends or I'd have solved the puzzle by now.'

He wiped sweat from his face as he flipped a page in the book.

'I can't even keep track of geography anymore,' he murmured as he turned past the section on scrub typhus, having been intently reading it when Cuddy had started putting the books away.

Cuddy sat down again, pulling the chair closer to the desk and leaning over it, her left elbow on the surface and right arm laying straight out so that her hand was laying atop the book that remained unopened. She opened the cover quietly, thumbing at the edge of it until he reached up and laid his hand atop hers. She stared at their hands, expecting him to move her hand away from the book because the noise was annoying him, but instead he just kept his hand there.

'There are so many variables,' he said as his index finger began rubbing the top of her lower hand and wrist. 'For example, are the seizures caused by epilepsy, her two "contraindicated in patients with a history of seizures" medications or the disease process? Since it's been so long since her last CD4, has she lost elite controller status and begun having issues with her immune system?'

He was quiet for a moment, moving his hand to lace his fingers in hers.

'Even if we did decide upon some cause, how would we test for it? If she remains critical, we won't have time to take specimens to Kumasi, and hell, even if we did have time, who's to say if they'd have the special media needed for some testing or properly trained personnel to run the tests?'

'If we make a diagnosis, we'll just treat her and hope for the best.'

He laughed, leaning over to lay his head between the open and closed books.

'How good are you at starting IVs?' he asked after a minute, his voice muffled by the position of his head.

'It's been forever since I did one,' she replied, looking down at his head as she slowly reached out and began running the fingers of her left hand through his hair; she furrowed her brow at how hot his skin was. 'I was mediocre at best in med school.'

'I need more morphine.'

'If it's your leg, we could just inject directly or do another intrathecal injection.'

'God, no spinal access _here_, please,' he said then continued. 'It's generalised myalgia.'

Her hand paused in his hair.

'Are you sure you're okay?'

'Pain is nothing new,' he responded after a long pause.

'You didn't sleep last night, you have a fever, you can't concentrate and you have generalised myalgia,' she said, taking her hand from his. 'New.'

They were quiet again as Cuddy considered this development.

'Where's your carte jaune?'

'Tucked in here,' he replied, fishing his passport from his pocket but managing to keep his head on the desk.

She took the blue-covered passport and flipped it open, looking at the information page. Upon viewing the page, she raised en eyebrow at how pleasant he looked in his photo -- according to the date of issue, he'd received a new passport during the gossamer days following his ketamine coma. Shaking it off, she flipped through the other pages. On page seven, Dr James Wilson written as the emergency contact just as he was in her own passport; the area between pages twelve and thirteen housed his WHO International Certificate of Vaccination. Dropping his passport onto the desktop, she snapped open the yellow card, folded it open to stare for a moment at the large AB+ that he'd written in what seemed like Sharpie, then looked over the area for 'medications taken regularly' -- her own signature graced the right hand column to say that yes, he needed to have Vicodin ES, hydrocodone/APAP, for chronic pain -- and then followed to the area for other vaccinations he'd received: tetanus/diphtheria booster, polio booster, MMR booster, hep A, hep B, Japanese encephalitis, typhoid...

'Rabies?' she asked, looking across at him.

'Can't be too careful,' he replied, then took a deep breath. 'Wilson and I gave it to each other on a whim.'

She had a feeling that any whim that Wilson and House had involved border skipping, but she didn't dwell on it for sanity's sake. Looking back at the paper, she scanned to the last item on the list: influenza, 0.5 mL dose.

'You've had your influenza shot, so I don't think it would be the flu.'

'The shot's required by the hospital.'

'Doesn't mean that you actually did it.'

Another laugh, this one decidedly darker. 'Maybe I'll get the same thing Natalie has and we can use me for the control.'

She frowned, standing and looking down at his head as she put his carte jaune back in his passport and set it down beside him. He breathed softly before sitting up and leaning back in the chair, his glasses tipping back to rest on his forehead.

'You get on me about my Malarone,' she said, resting her fingertips on the desk surface. 'How good have you been at taking anything but Vicodin?'

The silence was deafening.

'Oh, the hubris,' he finally responded.

'Oh, House,' she replied with a long sigh. 'I'll get Anna.'

When she'd left the room, he stared blankly at the desktop, leaning forward and flipping a few more pages in what was rapidly becoming a feverish daze. He tried to focus on the book once more but quickly gave up and just laid his face right in it. He only looked up when the door opened and the two women walked in. Cuddy pulled a chair around to him, encouraging him to sit up and lean back as Anna walked past them and into the storage room, coming back with a tray of supplies which she set down on the table. Cuddy moved to stand behind House as Anna sat down in the chair.

Anna didn't speak to him as she held his hand in her gloved hands, rubbing at the left middle finger with an alcohol pad and squeezing the finger toward her to stimulate blood flow to the area. When his fingertip was sufficiently reddened, she took a lancet and pierced the skin, applying pressure and milking the finger until a bead of blood appeared atop the skin. She quickly wiped it then turned his hand over, allowing three fat drops to collect on the surface of one of the glass slides. Cuddy picked up the alcohol pad Anna had used then discarded into her lap and handed it to House. Anna, scanning the slide for a moment, grabbed another slide and turned away, spreading the blood to make a thick, circular film.

'I'm stain and examine it once the blood has dried,' Anna said casually as she carefully set the slide on a paper towel in a metal tray.

Cuddy's eyes followed Anna as she stood and picked up the tray, walking away from the desk. House's vision remained focused down at his lap and his bleeding finger.

'I hear it's hard to see the bacteria if one isn't properly trained,' House said, finally pressing the alcohol pad to his finger.

Anna kept walking and disappeared into the supply room, which apparently also doubled as a lab.

'Her father is a molecular biologist. She worked in his lab,' Cuddy murmured as she gave him a sideways look. 'Please stop pestering her. The conversations between you two are already desultory enough and I don't want to get to the point where both of you have dissolved into children and I'm the middleman in all pertinent discussions.'

'But internecine battle is a perennial favourite of mine,' he responded, closing his eyes and groaning lightly.

'Have him lie down in the bedroom,' came Anna's voice from the laboratory. 'It'll be a little bit before I get the slide prepared.'

Cuddy looked down at him as he pulled away the alcohol swab -- the finger had thankfully stopped bleeding.

'Come on,' she said, taking the back of the chair as he reached out to put his flattened hands on the desk.

She had to reach out and grab at him as he began falling to the ground, but he mostly got up on his own. Nothing was said -- both were educated enough to know the intricacies of orthostatic hypotension. Despite having his cane, he used Cuddy as his sole support as he left the room, his arm thrown over her shoulders as they walked. They went along the corridors, House focusing on the group of women and children gathered in the courtyard. The women were all at different stages of doing the clinic laundry using the rain water from the last day and long pieces of yellow Key Soap to grind at the clothing. He heard Cuddy laugh lightly and looked down at her. She was smiling, also focused on the group.

'Dɔketa!' yelled one of the women right as they got to the door of the bedroom. 'Here, come here.'

Cuddy stopped, looking at House then toward the woman.

'Yes, you, come,' she continued, gesturing. 'You learn.'

House gave a little snort laugh and she gave him a covert dark look before smiling perhaps a little too forcefully.

'I'm sure I won't be much help.'

The women all laughed, saying something amongst themselves -- despite the language barrier, both were able to discern that they were in agreement. All started nodding and gesturing again so Cuddy sighed lightly.

'Do you want to go into the bedroom, or--'

'I'm not going to miss this despite how shitty I currently feel.'

Grumbling slightly, she helped him over to an area at the edge of the walkway, watching him settle in a sitting position against a pole. Once he seemed vaguely comfortable, she walked over, both aware and unaware that he was intently watching her ass with a tilted head. He watched her as she stopped by one of the women and accepted a worn-down bar of Key Soap, one of the women saying in the course of dialogue the word 'OXO', likely mentioning that the obruni was going to be useless with a bar of Key.

She was right, and soon all that House was hoping was that Cuddy would splash her water with just slightly better aim so that her white tank top would be wet somewhere other than her waist. After five minutes of embarrassment and laughing from both the women and the children, who had stopped their play to watch her, the women finally accepted their Key once again and went back to washing as she wandered back over to House. He smirked.

'I actually feel a little better after witnessing that.'

She didn't give a verbal response, instead opting to gracefully hold up her left hand to cover the middle finger she was giving him with her right. He chucked at her before both focused on the children playing in the courtyard. The one who appeared to be the oldest of the all-girl group grabbed a toddling sibling and picked her up by one arm, slipping her onto her back and pulling a cloth about both of them, securing it with two simple tucks before beginning to play again. House continued watching with a raised eyebrow as she started playing some odd jumping and clapping game with two others, the baby still on her back, both unconcerned by this action.

'They certainly start mothering early,' House offered.

She gave an affirmative noise.

The baby seemed to slip down some on her sister's back and Cuddy hissed, beginning to stand up and move forward before the girl reached behind her and shoved the baby up, holding her as she moved over to the corner of the courtyard to an area where the women had laid a thatch mat to cover the wetness from the rain. Pulling her sister from her back, the eldest girl set the baby down on the ground and went back to playing. After watching the girl for a moment, Cuddy stood up from her half-crouched position and wandered the five feet over to the girl. House considered joining her before remembering his previous orthostatic hypotension and realising it was just not a risk he was willing to take. He leaned against the post more, watching her approach the baby as one would approach a bird.

'That one is afraid of obruni,' said one of the washing women. 'Do not pay her much mind if she is upset.'

House set his elbows on his knees and watched her. She had sat down on the other side of the mat, her arms around her knees as she watched the baby play with a side of a broken wooden clothespin. After a minute, she reached out to brush the baby's arm; she immediately began to scream, already-prepared tears running down her face. Cuddy retracted her hand and she grew quiet once more, jamming the wood into her mouth as she looked up at Cuddy.

'She's terrified of white people, Cuddy.'

The baby focused on house and started crying once more. Somewhere in his core, he cackled maliciously.

'Shh,' said Cuddy, reaching over to rub a knuckle against the baby's spine.

She responded by gnawing on the clothespin once more, still sobbing. Summoning all of her fortitude, Cuddy reached out and picked her up, remaining sitting in case of the need a sudden set down to avoid a meltdown.

'She won't like that,' said one of the older girls -- all of them had stopped playing to stare at the scene unfolding in front of them.

'It's okay,' Cuddy murmured just audibly enough for House to hear as she held the baby close, one hand under her butt and the other pressed to her upper back. 'Shh.'

The baby looked at Cuddy once more before reaching out and taking one of her curls, going quiet as she studied it. Upon seeing that the possible screaming explosion had been avoided, the girls returned to their play, but House remained focused on the pair. Cuddy was smoothly rocking from side to side, her slight movement lulling the baby. Whenever the baby would start to make another noise, she would hold her closer and shush her again. After a few minutes, there was complete silence between the two as Cuddy bent her head down to press her forehead against the small girl's crown.

'They're a big family, aren't they?' Adzoa asked as she walked by with a tray of supplies.

'They're from _one_ family?' House asked, taken aback.

She nodded. 'Large families are common in rural areas.'

He gave another mystified and slightly disturbed look. She laughed.

'Oh, Dr House, you look very scared that Dr Cuddy is going to start asking for a baby.'

Immediately, Cuddy stopped rocking. She turned to look at House before closing her eyes. Without thinking, she leaned back and removed the hand from the baby's back, reaching up to tuck her hair behind her ear. The change in position led the baby to cry again, so Cuddy carefully pulled her away and set her down in the same place where she'd been playing. She was oblivious to any change in mood, immediately returning to her clothespin. Cuddy stood, walking past the two of them with her head bowed. She disappeared into the bedroom.

Both looked after her, Adzoa's mouth hung open with unspoken phrases.

'What did I say?' she finally asked in a hushed voice.

'It doesn't matter,' he replied, slowly pulling himself to his feet with the help of the pole and his cane.

Adzoa nodded, quickly moving on in her task to avoid awkwardness. House followed Cuddy's path slowly, walking into the bedroom and closing the door behind him. She was sitting on the bed as he leaned against the door.

'I'm sorry for leaving you there,' she offered, flexing her hands on the sheets.

He shook his head as he tapped the end of his cane on the floor.

'She didn't mean anything by it, Cuddy.'

'That doesn't make it hurt any less,' she replied.

He crossed the room and sat down next to her exhaustedly, grabbing his leg before he fell back on the sheets. After a moment, she joined him, falling back so she too could stare at the defunct ceiling fan.

'I'm being stupid.'

'Not here to pass judgment,' he said.

This wasn't a typical Housian comment, but she let that fact slide as they laid in silence right next to each other. He shifted, setting his hands by his side before shifting to set his head on the pillow and his feet atop her stomach. She wiggled out from under him, scooting up to the top of the bed and sitting with her back to the headboard. He laid his hands on his stomach.

'Why did you stop the injections?'

'You're ludicrous to think this is the time and place to discuss this.'

'Where exactly is the correct venue for the conversation?'

She sighed theatrically, rolling her eyes and leaving her gaze on the dresser across the room.

'It's obviously not meant to be.'

He rolled toward her, looking up.

'You're in your early forties,' he said. 'You still have plent--'

'Don't do this to me, House,' she said sternly, looking down at him.

In the back of his mind, his biting words to her the year before echoed and he suddenly felt the quite foreign emotion of guilt. Reaching over, he took her right hand and laced it into her own.

'It's all right,' she said in a very tiny and rather unconvincing voice. 'I'll get over it.'

There was yet another length of silence before House spoke.

'I'm sorry.'

She furrowed her brow, looking at him as she slinked down lay her head on the pillow.

'It's not your fault. You tried to help, you--'

Suddenly, he closed the distance between their lips, destroying the end of the thought. She quickly gave in, participating in what rapidly became a one-sided assault on House's tongue. He moaned approvingly into her mouth before furrowing his brow in thought, stopping the kiss just as rapidly to turn his head and look at the white board. She gaped, watching him.

'I know what it is.'

She moved her mouth soundlessly before articulating her thought.

'What?'

'It's dengue fever,' he said, turning back to her with that post-diagnosis fire in his eyes. 'The right season, the right symptoms...'

She considered this for a moment, staring up at the whiteboard as she set up to her elbow.

'Break-bone fever,' she said with a slow nod.

'With a positive tourniquet test,' he replied.

'And the rash on her face.'

She continued staring at the board as he looked over at her, watching her expression as the ambient noise of laundry and children echoed outside of the door. After nodding again, she sat up and scooted down to the end of the bed, standing up then turning back to him.

'I'll go tell Anna; you try to sleep.'

'Could you grab the APAP from the bathroom before you go?'

'Oh,' she said, her eyes wide for a moment. 'Yeah, of course, sorry.'

She took a few quick strides to the bathroom, opening the medicine cabinet and searching through it to pick out a red-topped bottle of acetaminophen. As she walked back to him, she absentmindedly shook the bottle before carefully setting it in the middle of his chest. He grabbed it as he slowly sat up with Cuddy's hand on his upper back to steady him. After twisting the top off, he tapped two pills into his hand and dry swallowed them. He leaned back against the headboard before slipping down and laying on his side. Once she assured he was properly positioned, she began walking toward the door again.

'I'll be back soon.'

The women had started hanging the clothing and linens on long cords that spanned the courtyard, so she took the corridors around to avoid getting in their way. She'd almost made it to the office when she nearly ran headlong into Anna, who was exiting with a baggie of pills.

'Dengue,' Cuddy spurted without encore.

Anna looked confused for a second before comprehension set in. She fumbled, handing the pills to Cuddy.

'Malaria,' she said, then wandered in the direction of Natalie's room.


	20. Chapter 19

'Something doesn't seem right.'

Cuddy, who had been crouched over her paperwork, looked up, her right hand resting on her left shoulder. House was standing at the foot of Natalie's bed, his cane hanging from the footboard as he watched the woman sleeping. She had been a little more lively since they began treatment a day and a half earlier, sitting up on her own to dangle her legs off the side of the bed. Her fever broke soon after a vaguely normal fluid balance was restored and the muscle pain was decreasing, but she had suffered two more nosebleeds and the rash covering her face and now her shoulders and back maintained its tenacity. It seemed as though she was bruising more, but when Anna mentioned it, Natalie assured her that she was always an easy bruise then immediately changed the subject to whether or not Anna was planning to do her job and go out to do house calls. That was what Cuddy was preparing for -- as House was still recovering from malaria and was prone to just sort of dozing off, they decided as a group that Cuddy was going to be the doctor this time around. She was sincerely hoping that nothing was labeled palliative.

'What do you mean?' she asked after an extended pause.

'I just feel like she should be improving more than this,' he replied, crossing his arms as he stood on his left leg to decrease the use of his aching right leg. 'I must have missed something.'

She watched him for another moment before returning to the paperwork.

'We should run a CBC,' he said. 'Surely the hospital in Damongo can do that. Will you be driving through Damongo today?'

'You'd have to ask Anna,' Cuddy replied.

'Maybe she could run one here,' House said quietly.

Cuddy looked down at Baring as she began thumping her tail under the desk before walking over to Natalie's bed. The dog half jumped so that her front paws were on the siderails, looking expectantly at the now partially awake Natalie. Natalie closed her eyes again and yawned before slowly sitting up straight and leaning slightly forward with her hands folded in her lap. She opened her eyes to look at House, both staring at one another until House leaned closer to narrow his eyes at her. He fumbled for the penlight in his pocket, clicking it on as he kept his focus on her.

'Open your eyes more.'

She sighed, reaching up with both hands to hold her eyes open with her index fingers and thumbs. He held the light up and studied both eyes before echoing her sigh.

'Conjunctival hyperemia,' he said as he looked at the power button at the top of the light, clicking the button over and over again before throwing it back in his pocket.

'Probably just conjunctivitis, House,' Natalie replied dryly.

Without even thinking, Cuddy slightly turned her hands away from Natalie and House leaned back slightly.

'We can try some cipro eye drops and if that doesn't work, then we know it's hyperemia,' said Anna from the door, holding Martin by the collar as she walked in. 'Are you ready, Dr Cuddy?'

'I think so,' she responded as she began closing the files in front of her; as she closed the last one, she looked up at House. 'Do you still want the CBC?'

'No,' Natalie said dourly. 'If you're so talented, figure it out on your own.'

They all looked at her but none were willing to start a clinical battle. Anna tipped her head forward slightly as she brushed her hair behind her left ear.

'We'll just continue monitoring her fluid balance,' she said with a shrug. 'Adzoa can handle this, Dr House. You should lay down.'

House didn't seem to even entertain this idea, instead moving over to sit in a chair across the room from Natalie so that he was in a position to watch her, look at the whiteboard and thumb through a few of the books he'd looked at earlier. Cuddy stood, gathering the files in her arms and turning to Anna.

'I'll just drop these in the office on the way out.'

Anna nodded, stepping aside to let Cuddy out.

'Anna,' Natalie said, reaching up and scratching her face with her right hand as she looked down at the self-contained pulse ox on her left index finger -- she waited for it to beep and read the sats before continuing. 'Go to check on the Mante infant first.'

'They may be the only family we're able to see today due to the weather,' Anna said, reaching over to pluck one file from Cuddy's arms.

'A large family -- just go ahead and make sure everyone is fine until next month,' Natalie replied with a yawn before waving Anna off.

'Okay,' Anna said with a quiet nod before following Cuddy.

Once they'd left, Natalie pat the bed and both dogs jumped up with her, cramming themselves on either side of her. She soon fell asleep again, leaving House to synthesize a new solution.

---

It was pouring by the time they reached Buipe, 1:29 according to the analog watch that Anna had hung from the rearview mirror. Cuddy watched the seconds click away on the white background, the second hand actually being a rising sun plate ticking about over the face. They hit a pothole and muddy water sprayed on Cuddy's window; she looked over at it for a few long moments before turning back to the book about practising medicine in an area where there is no doctor. It had been a very long time since she did anything even vaguely resembling a peds case aside from overlooking the OB/GYN department at Princeton-Plainsboro, so the thought of dealing with something as fragile as an infant in a still-unfamiliar area was slightly nervewracking.

'The Mante is a family of one man, his three wives and a combined total of six daughters and four sons,' Anna said -- by this context clue, Cuddy was able to relax with the knowledge that Anna only came along on the 'palliative' cases of Catholic family, which this family apparently wasn't. 'The main patient today is the newest son, whose chart was among those you were looking at earlier. To save time for us later, I grabbed the rest of the family's files so we can go ahead and deal with any other minor complaints. They live pretty far out, so it's best to get them all in one fell swoop.'

Cuddy closed the book and looked over at her.

'Where are the other files?'

'In my bag in the back, but really, there aren't a lot of medical complaints in the family,' Anna replied. 'His second wife, Enyonam, worked at the district hospital before marrying Kwame.'

Cuddy considered this for a moment. 'Isn't the doctor in Kumasi named Kwame?'

Anna nodded. 'It's a pretty common name, a day name. They were both born on Saturdays.'

'Ah,' Cuddy said as she ran her right index finger nail down the outside edge of the cover of the paperback in her lap.

'Anyway, she's good at determining if we're actually needed to come in and intervene medically. She knows it's a long drive.'

They were quiet for a moment before Anna continued.

'Natalie was at their house when she had her first seizure,' she said, then realised the need to be conditional. 'Well, the first seizure that she's had in Ghana.'

Cuddy seemed slightly taken aback. 'It seems like that would have been a good thing to mention to Dr House. Had she spent a lot of time there prior to getting sick?'

'No more than she does with any other prenatal patient, and she's had three in the last two months.'

'All in the same area?'

'If only it could be that easy,' Anna said with a sad laugh. 'They're in all different directions.'

'What are the demographics of those families?'

'How is that relevant?'

'It's just a question,' Cuddy snapped back, and Anna looked over at her seriously.

'Both of the others are in single couple families. One has three children and the other has five,' Anna said. 'The mother of the three is in her early thirties and the one with five is nearing forty.'

'How old is the Mante wife?'

'Ama is his youngest wife,' Anna replied. 'She turned sixteen a few months ago.'

Cuddy raised her eyebrows but said nothing.

'Secretly I agree, but it's not my place to judge,' Anna said in a small voice as she made a sharp turn onto a road that appeared to consist entirely of sludge.

It was another thirty minutes before they turned into the millet field -- the total drive had been well over an hour. Since Natalie had been there a little over a week earlier, the millet had grown thanks to the sudden influx of rain. It was still too early for a hearty crop, but the weather made a good harvest seem increasingly likely.

'She rode her bike here that day,' Anna said, looking sideways at the rain-soaked stalks of millet. 'It was such a miserably hot day. It was really dry in February and the early part of March but we'd had a lot of good rains for a week or so mid-March only to get slammed by more dry weather. We'd thought that the Harmattan was going to end early this year only to have Harmattan, part two.'

'Did those storms leave a lot of stagnant water for the mosquitoes?'

'Not particularly,' replied Anna with a shrug. 'The mosquitoes haven't been that bad this year, to be honest. We've been lucky so far, but these rains might change that shortly.'

As they came up to the house, Cuddy saw some of the Mante children setting out large tin bowls to catch the falling rain, all of them laughing loudly enough for Cuddy to hear them over the roar of the motor. One of the older daughters stood directly in the rain with her arms outstretched, her face turned toward the sky with closed eyes. She tipped down her chin slowly as she heard the Defender's approach, turning her neck slightly to say something to her siblings. Another girl stood up from her bowl, looking at the car before heading to the door. The older girl was at the door of the car as soon as Anna turned the engine off, immediately sticking her hand out when the door opened. Anna shook her hand, snapping against the younger girl's thumb and index finger as she dropped down to the muddy ground. Cuddy slipped out of her side, arms clasped tenaciously to her chest, and came around, her hand held at her forehead to shield her eyes from the rain.

'This is Tabitha,' Anna said. 'She's the oldest daughter. I'll gather the supplies if you follow her into the house.'

Tabitha took Cuddy's hand, leading her past the bowls, all of which had turned into lesser versions of temple bells. As they walked past, Cuddy could hear each raindrop reverberating against the tin, the sound creating the slightest of hums, each lapping against the dozens of others occurring at around the same time. There was the shush of the wind through the millet as they reached the door, the breeze bringing the previously static collected rain rushing down the grooves of the tin roof, one of the streams drizzling down on Cuddy's left arm as she stepped onto the stone slab where Tabitha stopped to study her muddied feet for a moment. Cuddy pressed to the damp outer wall of the house as she found herself glancing down at her now muddy and squeaking flip-flops. Tabitha opened the door, rubbing her feet on a reed rug as Cuddy removed her shoes and did the same. The family had gathered in the central room, the younger children who had been playing outside having obviously entered the house from the back door. All were still soaked, wrapped in threadbare towels as they watched the oldest of the wives pour steaming soup atop a large ball of fufu that was set on the table in front of her. Once the pot was empty and the fufu thoroughly doused in liquid, she picked it up and put it in the circle of the four children old enough to feed themselves. A murmuring of small voices down one of the hallways was enough for Cuddy to ascertain the location of the five other children.

'You must be Dr House,' the woman said as she stood -- all of the children looked up at Cuddy.

'Oh, no,' Cuddy replied. 'Dr House is my associate; I'm Dr Cuddy. Dr House is working with Dr Chase today.'

'I hear she isn't well,' replied the woman.

'I'm afraid not,' said Anna as she entered the house. '_Mma aha, Enyonam. Wo ho te sen_?'

'I'm fine,' Enyonam said, giving a smile and understanding look to Cuddy. 'How are you today, Anna?'

'Wet,' she replied as she walked over and set her bag in a chair pulled up to a strong wooden table.

Tabitha laughed lightly before breaking away from Cuddy and heading over to the kitchen where she picked up a bowl of rice and poured some of a different soup upon it. She walked over and sank to the ground near her siblings, taking a few bites of her dish before handing it to a girl around her age. They continued sharing the bowl rather than turning to what the others were eating.

Anna watched them for a moment before knitting her brow.

'Where's Kwaku?'

'Ill,' Enyonam replied. 'I knew you'd be coming today, so I didn't make a special call.'

'How long has he been sick?' Anna asked worriedly.

'Two days,' she responded. 'It seems to be the grippe.'

'Seems a little out of season,' Anna replied, shifting on her feet with her arms crossed. 'Are you sure it isn't malaria?'

'It doesn't seem so to me, but I will leave it up to your judgment,' Enyonam said as she reached out and put her hand on Cuddy's upper arm. 'Come, I will take you to him first.'

'I'll check on everyone else while you're in looking at him,' Anna said as she fished a stethoscope and thermometer from the bag and extended them toward Cuddy.

Cuddy looked down at the files in her hand and plucked out the one for Kwaku, setting the other files next to Anna's bag before taking the proffered supplies. Enyonam smiled at her once more before leading her down the hallway. They shuffled along together, the sounds of the chattering children fading into the tapping of the rain on the tin roof. The sounds faded once more as they came upon a duo of women engaging in bavardage. When they stopped at the door, Cuddy saw that the older of the two was nursing two very young children and the younger was nursing a tiny newborn as two other children sat on a reed mat playing with a cowrie-webbed gourd. The younger woman didn't look that much older than Tabitha.

Enyonam said something quickly to the two of them before leading Cuddy to the next doorway, which was covered by a piece of batik hanging lazily from waxed twine. She slid it to the side, stepping in before Cuddy to pull away the curtain to let in some light and then strike a match to light the lantern next to the boy's bed. He groaned softly and put a hand to his face.

'Kwaku, this is Dr Cuddy. She is here in the place of Dr Chase.'

He carefully lifted his hand slightly to look at her, but the emotionlessness on his face did not change. After a moment of looking at her, he dropped his hand again.

'Have you been able to take his temperature?' she asked as she walked over and sat on the edge of the bed.

'No, but it has been high enough that he has been shivering.'

Cuddy nodded lightly as she pulled out the probe of the thermometer and shoved a cover on it before edging the probe into Kwaku's mouth.

'What other symptoms has he had aside from the fever?'

'Very tired, pains, headache when he is in the light too much.'

Cuddy knit her brow before speaking softly. 'It does sound like the flu, doesn't it?'

The thermometer beeped and both looked down at the screen -- it read 38, a moderately low-grade fever. Cuddy drew her mouth to the side in exasperation before taking the stethoscope and putting the earpieces in. She warmed the diaphragm before setting it on Kwaku's exposed chest and listening bilaterally to his lung sounds.

'Stomach pain,' Enyonam offered, and Cuddy closed her eyes for a moment to synthesize this new information.

'How old is he?' she asked as she took the earpieces out, not opening her eyes to look at the patient file on the sheets by her knees.

'Ten,' Enyonam replied.

'Influenza B,' Cuddy offered after a moment. 'All of the symptoms of the flu with stomach pain in children. He'll just need plenty of liquids along with some paracetamol. Make sure he coughs and deep breathes multiple times daily until his lungs clear to decrease the risk of pneumonia.'

'I'll have one of the other children collect one of the water bowls we've put out in the rain for him to have very fresh water.'

'Good,' Cuddy said with a nod as she examined Kwaku's arms -- there were a couple of bruises, but none out of the ordinary for a young, active boy.

Enyonam was quick about closing the curtains and turning off the light, kissing Kwaku's forehead before leading Cuddy out into the hall once more. As they walked back toward the living room, Anna was coming toward them.

'It looks and sounds like the flu to me,' Cuddy said.

Anna bit her bottom lip with a nod. 'Seems odd, but a lot of things are around here.'

'You've already looked at all of the children?' Enyonam asked.

'Just a quick overview,' Anna replied. 'They all seem to be doing very well. I'm about to go check on the baby and the other four.'

'I'll help,' Cuddy said to her, coming one step closer to her.

'Okay,' said Anna with a light laugh.

'I'll have one of the others get the water for Kwaku,' Enyonam replied before brushing past them to go to the main room.

Once she'd gotten to the older children, the two clinicians stepped into the room. Anna directed Cuddy to check the women, accurately picking up her discomfort regarding the treatment on young children. The younger woman wasn't one for English conversation, but the older one was very chatty. The examinations were cursory as both women seemed healthy, so Cuddy was finished before Anna. She sat down in a chair next to the younger woman, looking down at the baby for a moment before scanning the room. There were piled tin bowls, folded reed mats and lengths of dusty fabric lining the walls. As she looked closer, she realised that some of the reed mats were shredded in areas as though knives had been taken to them. She sat up straighter in her chair in thought before Tabitha walked in.

'We need another bowl for water,' she explained as she crossed the room and reached up to grab a bowl off of a shelf.

Unfortunately, as she reached up to grab it, she pulled down the entire stack of six bowls without adequate support. They fell to the ground, clanging horribly before coming to rest on the dusty ground. The younger children cried as the others ran toward the noise to see what had happened. Tabitha began sheepishly piling the bowls until reaching the fourth, which had turned over. As she lifted it, Cuddy saw some of the missing reed mat material at the same time that she saw three rats scurry away from their nest. The room exploded into even more mayhem as everyone started screaming, Enyonam and one of the other girls whacking the things away with reed fans as Cuddy and Anna instinctively moved to pick up the two younger children who were sitting on the ground. The unusual clamor woke other rats up, the small mammals scurrying from the shelves and out a fabric-covered window hole. Anna and Cuddy stood on the reed mat staring after them in stunned disbelief.

After a few minutes, it had growth quieter again. Cuddy and Anna watched as Enyonam and Tabitha took down everything from the shelves, checking every corner for other rats. They spoke angrily the entire time, batting at nonexistent rodents as they cleaned. The bowls were laid out in front of Cuddy, awkwardly stacked but ratless. One of the younger children walked in and said something slightly sheepishly and Enyonam replied before the boy grabbed one of the bowls and started to walk out of the room. As the inside of the bowl reflected oddly in the light, Cuddy reached out and grabbed his shoulder.

'Wait,' she said, squatting to put the younger child down before taking the bowl from the boy's arms.

She held it in the light, tipping it from side to side with furrowed brow before looking over it to Enyonam.

'Do you clean these bowls well before using them?' Cuddy asked. 'With bleach or Oxo or Key?'

'Just water,' Enyonam replied.

'Only when there's enough water,' Tabitha said, and Enyonam looked over at her.

'Always wash the bowls, Tabitha.'

Cuddy looked at the bowl once more before looking over at Anna.

'It's not influenza,' she said in a solemn half voice as she looked down into the bowl again. 'And it's not dengue either.'

---

A/N: Augh, I'm so sorry about the delay! A thousand things have happened in the last month and Occlusion sadly had to be put to the side for a moment. Here's to hoping for better, faster updates again!!


	21. Chapter 20

Anna hardly had time to stop before Cuddy threw the door of the Defender open and jumped out, her legs falling out from under her as she hit mud instead of solid ground. Grabbing at the inside handle of her door, she used her upper arms and shoulders to yank herself upward and paused for a moment to steady herself before setting off toward the clinic. She ran up the stairs, her feet leaving pale reddish brown smudges on the wet concrete. She turned, nearly losing her footing again due to a puddle that had formed around the perimeter of the courtyard. Anna made it to the top of the stairs in time to see Cuddy go into Natalie's room. The younger woman followed her footsteps, walking in to look at Cuddy standing in an empty room. Anna put a hand on the doorframe, waiting for a moment before taking a hesitant step forward. Cuddy stood next to the bed, a fistful of bloody linens in her hand as she looked down as though the patient would reappear if she rustled the cotton enough.

Cuddy looked up at her. 'Where did they go?'

Anna had opened her mouth to say something when Adzoa quietly appeared at the door, water beading in her hair. She spoke demurely. 'Sister Anna.'

The look on Adzoa's face gave Cuddy a sinking feeling in her stomach. Any good mood developed by the heady since of victory she'd had upon diagnosing Kwame dissipated as quickly as the rain had on the breakneck drive back to the clinic.

'We're too late,' Anna hazarded, bending forward slightly in a hopeful attempt to have Adzoa give them more positive news.

Adzoa allowed the briefest of smiles to cross her lips then shook her head slowly. 'It's bad, sister, but Dr Chase has not left us.'

The question of whether this meant she had shuffled this mortal coil or was simply elsewhere still hung heavily in the air, something that Adzoa obviously felt before continuing.

'She had to be taken to Damongo.'

Anna breathed a sigh of relief and looked at Cuddy, who dropped the handful of linen and began to walk toward them.

'What happened, Adzoa?' Cuddy asked as she reached them. 'Why did they go to Damongo?'

* * *

The same grasslands and trees greeted them on their way to Damongo. Mud sloshed up from the tires and flicked upon the windows of the Defender as they went along. No other vehicles or people passed them the entire way - even the little villages they went past were barely awake after the rains, though people were starting to emerge from their huts to begin building fires to cook dinner.

Anna's right hand flexed and unflexed compulsively on the steering wheel as they turned off of the main road and into the town.

On both sides of the road, Damongo was waking up from the rains. Although it was rapidly approaching evening, salespeople in their little stalls were intent on making up for financial losses for the day and were therefore staging their goods once more to catch any possible sales from people who had emerged after the rain. They stopped to allow a goat to pass and Cuddy watched a saleswoman wearing a hijab slide a makeshift wooden bridge over the canal in front of her store. These canals were on both sides of the road - the rains had made them swell, washing away the refuse and stagnancy that had collected over the previous days.

Once the goat passed, it was still slow going, something which tugged at the strained fibers of their beings. Cuddy tried to focus on her surroundings rather than her nagging doubts about the future of Natalie Chase. There was a chop bar with people sitting and eating jollof rice. Next to that, a kente weaver was carefully hanging his colorful scarves from a panel of dowels, his fingers deftly removing small knots from the fringe at the end of one that was colored the red, green and yellow of the Ghanaian flag. Another couple of doors down, a seamstress had thrown open the doors to her shop and had sat down once more to crank along her machine as she worked on a kaba made of green and gold waxed cotton.

Cuddy only looked forward again when they passed one of the ubiquitous furniture shops that also sold stylish coffins, many of the outfitted in mirrors. Cuddy wasn't a fatalist, but it was never pleasant seeing your own visage on the receiving end of a coffin. Why a corpse needed to check itself in a mirror was a mystery to her and to House the first time they'd walked by one of these shops on the way to grab Fanta one night.

The setting sun cast the long shadow of a baobab tree across the road leading up to the hospital. Although the grounds for the hospital were rather large, the entry to the West Gonja Hospital was very low key. A single four-by-four sign with fading painted letters announced visiting hours. Anna pulled over to the left of the sign, parking the Defender and stepping out. Cuddy followed, watching Anna carefully step on the muddy ground before getting to a poorly paved area right at the main gate. They made their way to one of the sidewalks crossing campus, following the signs to the public health ward.

Their shoes were still wet but much less muddy by the time they reached the building. Under the eave of the building, a sister clad in all white stood behind a patient in a wheelchair. She nodded a hello to Anna and said something in soft Gonja. Anna nodded back and they entered the building.

The floors of the hospital were tile rather than the poured concrete of the clinic. The ceiling was pristine, painted white with humming fluorescent bulbs running down the backbone of it. The walls were two-toned like most walls in Ghana were wont to be - this one was a Sahara brown to the tops of the doors then white to match the ceiling the rest of the way up. No one was directly in the hallway but their footsteps brought House to the doorway of a room down the hallway. He locked eyes with Cuddy before stepping back into the room.

'Why don't you go talk to Dr House and I'll go find the charge nurse?' Anna said, stopping suddenly.

Cuddy looked at her with uncertainty, but nodded. 'Okay.'

Without waiting to look back at her, Cuddy continued forward, reaching the door to the room and standing to look at the two beds. House sat on the edge of one looking across at Natalie, who was supine on the other. Cuddy sat beside him, her eyes drifting from the hub of the IV in his arm along the tubing and to a glass bottle of fluids that hung from the pole on his right side.

'I might have overdone it a little,' he offered in a tired voice. 'The last couple of hours involved a shitload of running and medical interventions, something the malaria was not fond of.'

'Your leg probably wasn't fond of it, either,' she hazarded, lightly rubbing his thigh.

'One of the good sisters morphined me up when she started my fluids, so I'm feeling pretty good right now,' he said, before motioning to Natalie. 'Chase, on the other hand...'

Cuddy slowly laced her fingers through his, both of them looking across to the other woman. Although she's feigned partial wellness for the last day, it was now completely apparently that nothing about her was even vaguely healthy. The warm glow of the setting sun filtering through the windows accentuated the bronzed hue of her skin. A plastic endotracheal tube was inserted down her windpipe, flesh-coloured tape looping from her right jaw, around the tube and back to her right jaw once more. With each forced air breath, the tube condensated, a tiny winter's day taking place in the space between her bronchial trunk and the joint where the ventilator hooked into the tube. Cuddy stood and walked over to her, taking her hand to look at the bruised skin and dusky fingernails. She furrowed her brow as she laid the hand back down, looking at her own hand and rubbing her fingers together to feel the salty texture that she'd pulled off of Natalie's skin.

'Uremic frost,' House confirmed. 'She's in renal failure.'

'It's not dengue fever,' Cuddy finally remembered to mention.

'I know,' he said, allowing her to continue.

'It's leptospirosis,' she said. 'Rats were nesting in the water bowls at the Mante house. If she put ungloved hands in contaminated water and happened to have a few little cuts, she's be open for infection. One of their sons has it.'

'It_ was_ leptospirosis,' House replied. 'Now we're dealing with full-blown Weil's disease.'

She turned around to face him. 'House, what happened when we were gone?'

'Oxygenation issues,' he started. 'On auscultation, I noted some fine crackles in the bases of her lungs. We gave her some IV prednisone and increased her oxygen, but it didn't help. She started coughing frank blood then just stopped breathing.'

Cuddy reached up to Natalie's face and rubbed some dried blood from her cheek with the pad of her thumb.

'We needed the ventilator, so we had to bring her here,' he continued. 'The chest x-ray showed inferior bilateral infiltrates.'

'Alveolar hemorrhage.'

House just nodded before laying back and situating himself in the bed, one arm behind his head as he looked up at the ceiling.

Cuddy watched him until he was comfortable then turned her attention back on the patient. Natalie's other symptoms were now glaringly obvious considering the confirmed diagnosis. Cuddy moved her hand from around Natalie's cheek and up to her left eye to slowly open it. The deep jaundice of both her skin and her highly icteric sclera spoke of outrageous hyperbilirubinemia, an indicator of acute liver failure and possible necrosis. The bruising on her arms and petechiae Cuddy noted on her uncovered leg showed thrombocytopenia. The far-too-regular rhythm of breathing afforded to her by the ventilator confirmed respiratory failure.

'I should have caught it at the fever with conjunctival hyperemia,' he said. 'It would have given us time to get her down to Kumasi.'

'Weil's is treatable,' Cuddy said, looking to him for confirmation. 'This can be treated.'

'Two weeks of Rocephin,' House said as he continued to look up at the ceiling. 'But with the widespread hemorrhage...'

The rest went unsaid.

* * *

A/N: Well hello there. I think that I've finally found the impetus to complete this! Since the last update, I graduated nursing school and have been working as a cancer research nurse for the last two years. I have the very cool job of administering first-in-man drugs to patients. My clinic's all happy in the pants because so many of our abstracts were accepted for presentation to ASCO, good times. But yes, I've been overloading myself with CEs for my OCN examination, so I figured _for the love of god_, maybe I can finally finish this. HERE'S TO ACCOMPLISHMENT.


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